Targeted Violence Awareness Class Request

Use this form to request a Targeted Violence Class from the Department of Public Safety.

Requestor's Name
First Last
Division/Department/Unit/Group
Date Requested for Class - must be mm/dd/yyyy format
MM slash DD slash YYYY

Please provide the date you are requesting.
Time

: Hours

Minutes

AM/PMAM/PM AM/PM
Email Contact Information
Phone Contact Number

Office of Emergency Management