Special Events Requests & Consultation – NC State University Police Department

General Event Information

If something does not apply, please enter "N/A"

Event Name/Title:*

Start Date of Event:*

End Date of Event:*

Start Time of Event:*

:

End Time of Event:*

:

Location of Event:*

Include room number if applicable

Type of Event:*

If Type of Event is "Other", Describe:*

Sponsoring College/Department/Group:*

Your affiliation:*

Admission/Registration Cost:*

Number of Attendees:*

Affiliation Make-up:*

VIP's Attending:*

Yes
No

Provide full name(s) of any attending VIPs:*

Tickets Sold at Door:*

Yes
No

Will there be an Admission/Registration Fee:*

Yes
No

Will there be Concessions/Food Sold or Provided:*

Sold
Provided
N/A

Will there be Products/Goods Sold or Provided:*

Sold
Provided
N/A

Will there be Alcoholic Beverages Sold or Provided:*

Sold
Provided
N/A

ABC and/or University Alcohol Permit Status:*

Will Inflatables, Tents, Fires/Flames, Smoke/Haze Machine or Generators be used:*

Yes
No

Contact & Billing Information

Event Point of Contact:*

First Last

Point of Contact Affiliation:*

Point of Contact Email:*

Point of Contact mobile number:*

Billing Contact Name*

First Last

Billing Department*

non-NCSU affiliated enter N/A

Project ID*

(6 digits, enter 999999 if you are non-NCSU affiliated)

Billing Contact Phone*

Campus Box #*

(4 digits, enter 9999 if you are non-NCSU affiliated)

Billing Address*

Street Address Address Line 2 City NC ZIP Code

Event Staffing Information

Number of Law Enforcement Officers Requested:*

Number of Fire Marshal/Medical Staff Requested:*

(Fire/Medical Coverage)

Number of non-sworn Security Personnel Requested:*

CAPTCHA