Special Duty Request Form Page

Application for Special Duty Employers

Requested Jobs: Dates - Start/End Times, # of Deputies Requested Per Job*
Please enter the dates, start/end times, and how many Deputies for each job being requested. EX. (11-25-2019 8AM-12PM, 2 Deputies Requested)
Requesting Company / Organization*
Requestor's Email*
Requestor's Billing Address*
Street Address Address Line 2 City State ZIP Code
Requester's Phone*
Duty Contact*

Person that will be present and/or should be contacted in the event of questions or concerns
Cruiser Requested?*
Type of Duty*
Any Special Instructions / Concerns / Known or Suspected Issues?*