Speaker Request Form

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Speaker Request Form

The department has experts in all aspects of law enforcement who are available to speak with school children, civic organizations or other groups. Topics include, but not limited to: personal safety, crime investigation, senior safety, highway safety, new drivers, computer crimes, internet safety for adults and children or Connecticut State Police: Who we are and what we do.

Please complete this online form to invite a member of our agency to your next event. Please send this form at least 30 days prior to your event.

Name of Organization Name of Event (If Applicable) First Name Last Name Location City State Zip Code Phone Number FAX Email Address Date Speaker Needed Time Speaker Needed Number of People Expected in Attendance What topic would you want a DPS representative to talk about at your event? Please provide some basic information about your organization. Please provide some information on the makeup of the audience.

Connecticut State Department of Emergency Services and Public Protection

Speaker Request Form