I.M.P.A.C.T. Unit Event Request

Complete this form to request the Brunswick County Sheriff’s Office I.M.P.A.C.T. Unit attend an upcoming event. Requests may be submitted by individuals, businesses, organizations, schools, community groups, or agencies.

I.M.P.A.C.T. Unit Event Request
Please note: Submission of this request does not guarantee I.M.P.A.C.T. Unit attendance. Requests are subject to availability, staffing, scheduling, and operational requirements. Please provide as much advance notice as possible.

1. REQUESTER INFORMATION

2. EVENT INFORMATION

If the event has a scheduled rain date, enter it here. Leave blank if there is no rain date.
I.M.P.A.C.T. Setup Time
Event Start Time
Event End Time
Rain Date Setup Time
Complete only if the setup time changes for the rain date.
Event Address
Event Address
Bldg/Unit # (if applicable)
City
State/Province
Zip/Postal
Country

3. PURPOSE OF THE EVENT

4. I.M.P.A.C.T. UNIT REQUEST

Requested Attendance / Services

5. SUPPORTING INFORMATION

Maximum file size: 5.24MB

Supporting information may help the I.M.P.A.C.T. Unit evaluate and coordinate the request.
Requester Acknowledgement: I understand that this form is a request for I.M.P.A.C.T. Unit attendance and that submitting this form does not guarantee attendance. I certify that the information provided is accurate and complete to the best of my knowledge.
CLEAR FORM

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