1

Organizer's Name

Organizer's Name

2

Organizer's Address

Organizer's Address

3

Phone Number

Phone Number

4

Email

Email

5

EVENT INFORMATION

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EVENT INFORMATION

Event Address/Location

Number of Adult Participants

Number of Children Participants

6

Invitation Flyers (if needed)

Email

7

Event Type (check one)

Event Type (check one)

Ice Cream Social

BBQ

Potluck

Children's Activities

Theme Party

8

Special Requests Please note: Requests cannot be guaranteed, but we will try our best.

Special Requests Please note: Requests cannot be guaranteed, but we will try our best.

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PHONE: 408-615-4875

EMAIL: crimeprevention@santaclaraca.gov

OR MAIL TO:

Santa Clara Police Department
ATTN:  National Night Out
601 El Camino Real
Santa Clara, CA 95050

PLEASE NOTE: The officers and City officials that come to your event do not give prepared speeches or talks on issues in your neighborhood. They can answer some general questions for you and your guests, but the intent for NNO is for the citizens of Santa Clara and the Police and Fire departments to unite on a more social level.

1. To receive a copy of your submission, please fill out your email address below and submit.
2. Email Address

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