Security Detail Form

Washington County Sheriff's Office
Request for Off-Duty Employment

Any citizen, business or other organization requesting the employment of off-duty personnel of Washington County Sheriff's  Office must complete this form and forward it in person, e-mail, or by Fax (251) 777-8626 to the Extra Duty Coordinator,

Request should be made with a minimum of ten (10) working days prior to the event.  This document must be filled out completely.

Chief Deputy Deshone Holloway

Washington County Sheriff Dept.

Chatom, AL 36518

(251) 777-8626

[  ] Profit

[  ] Non-Profit (Attach Paperwork)

[  ] Other: _____________________________________

Tax ID #:  _____________________________________

RPerson and or Organization Requesting Off-Duty Personnel:

Organization Name: ____________________________________________________________ Phone #: _______________________________

Contact Person:        _____________________________________________________________ Phone #: _______________________________

Email Address:         _____________________________________________________________ Phone #: ________________________________

Address:                    ______________________________________________________________ Fax#:       ________________________________

Location of Event:  _______________________________________________________________________________________________________

Address:                   _______________________________________________________________________________________________________

Description of Event and Type of Entertainment:

________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________

Will alcoholic beverages be served at this event?  Yes [   ]  No [   ]

Will alcoholic beverages be sold at this event?      Yes [   ]  No [   ]

Music Genre (If Applicable): _______________________________________________ Live [   ]  Sound System [   ]  DJ [   ]

Will the lyrics contain any vulgar or offensive language?  Yes [   ]  No [   ]

Will any admission fee, cover charge, donation, or ticket sales be accepted by you are an organizer?  Yes [   ]  No [   ]

If yes, explain and note dollar amount: _______________________________________________________________________________________

(Include Permits)

Approximate number of people expected to attend this event: ___________________ Age Range: ______ to ________