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2. Contact Name
3. Name of Organization
5. Phone Number
6. Alternate Phone Number
7. Email Address
9. Name of Event
10. Type of Event
    (Parade, memorial, school presentation, meeting, career fair, senior fair, camp)
12. Address for Event
13. City / State / Zip
15. Date and Time of Event
16. Is there a registration fee? If so, how much?
18. Which person or unit(s) are you requesting?
    (Sheriff Kilkenny / Bomb Unit / K9 Unit / CERT Team / Bike Patrol Unit / Senior Safety Rep / Motorcycle Unit / Honor Guard)
20. Website / Social Media
    Is there a website or social media page where we can find more information?
22. Additional Information
    Please let us know if there is any additional information that will help us determine whether we can honor your request.
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24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field