Confidential

POLITICAL PROTECTION REQUEST FORM

Government Official Name

Your First Name

Your Last Name

Email Address

Your Cell Phone #

How many days is this assignment?

Assignment Start Date

Approximate Start Time

Approximate End Time

During the course of this protective assignment, will the elected official host their own event?

If the elected official is hosting an event, please provide the name of the venue.

What is the address of the venue?

Will a vehicle be needed for this assignment?

Will any of the event(s) be held outdoors?

Describe any outdoor activities.

Briefly describe the schedule of event(s). Provide the schedule if available.

Is there a hold room for Elected/VIP guest?

Will there be other elected officials in attendance?

How many elected officials will be in attendance?

Please name expected the elected officials and/or VIPs

Will “other” elected official(s) have their own personal security?

If needed, provide the elected official’s POC for Member Security or Transportation

Will there be First Responders assigned to the event(s)?

None

Unknown

Local / State Law Enforcement

Paramedics / EMT

Capitol Police

Secret Service

FBI

Homeland Security

Will the event(s) have Ticket Takers / Check in Staff?

What method will be used to invite guest?

Are attendees issued credentials?

Ticket type

Will IDs be checked at entry?, i.e. DL, ID card

Will your staff be required to wear credentials?

Type of Credential

Please provide any additional details that is not covered above.