Safe Community Presentation Request - Crime Stoppers of Houston

Group Type*
Select School if the audience will be school staff/law enforcement or students. Select Community for all others.
Organization or School Making This Request*
School District If Applicable
Contact Information
Please provide information for our point of contact leading up to and the day of your request.
Contact Person*
First Last
Contact Phone #*
Contact Email*

Enter Email Confirm Email
Address*
Street Address City State / Province / Region ZIP / Postal Code

Request Information
Audience Type*
Please select the main demographic for the expected audience.
- Select One
- School Staff/School Law Enforcement
- Students/Adolescents
- Community Members/Parents
Please list the grade level of student audience.
Please enter 3,4,5 rather than 3-5. Please enter PK or K for Pre-Kindergarten and Kindergarten Leave blank for groups other than a school (HOA, after school programs, camps etc.)
Expected # of participants*
Date Requested*
Please select your first choice of dates.
MM
DD
YYYY
Alternate Date*
Please select your second choice of dates.
MM
DD
YYYY
Arrival Time*
Please provide the time that you would like your presenter to arrive.

: HH

MM
Notes
Please provide any notes about your request that you feel may be helpful.

Request Information Cont.
Do you need a Spanish speaking presenter?*
Would you like an in-person presentation or a virtual presentation?*
# of Presentations Requested*
Please specify the number of presentations that you are requesting for this date. This could be more than one in the case of a school that is requesting presentation for five different class periods.
Please enter a value between 1 and 6.
Start and End Time
Please list the start and end time for each presentation including a break period if requesting more than three presentations.
Is the address listed above the same location for this request?*
Location for this request
Street Address City State / Province / Region ZIP / Postal Code
Audio and Visual Capability*
Press and hold the shift key to make more than one selection.
Parking & Building Instructions
Please list any special instructions of where our presenter can park and/or requirements for entering your facility.

Contact Information