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Community Outreach & Education Request Form

  1. Community Outreach & Education Request Form
    The Coon Rapids Police Department values the opportunity to speak with community groups about safety, crime prevention and other topics relevant to modern policing. We will make every attempt to accommodate your request. Due to the number of requests and limited resources, please note that we may have to schedule alternate dates, or in some rare cases, we may not be able to honor your request. To request an appearance or speaker for your event, please complete this request form no less than 2 weeks prior to the event date. Please note that this form is a request, not a confirmation - the event is not confirmed until you have received confirmation/verification from our department.
  2. Contact Information
  3. Please note in the "comments" box if the day-of contact will be different, along with their name and contact information.
  4. Organization Type/Audience
  5. Audience Type*
  6. Please specify the "other" audience type
  7. Event Details
  8. What is the time commitment for this event
  9. Choose a topic that suits your event (select all that apply) *
  10. Please note any additional information, for example: "other" topics, audience type, or anything you feel we should know.
  11. Leave This Blank:

  12. This field is not part of the form submission.