SECURITY SERVICES REQUEST
Florida Institute of Technology
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Oce of Security
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150 W. University Blvd., Melbourne, FL 32901-6975
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321-674-8112
20200148—1 of 2
Events requiring security—Remember, the larger the event, the higher the risk.
The completed Security Services Request Form must be received by David Cash, no fewer than 30 days prior to your event in order to allow time to process and staff your request. If your request is submitted
less than 30 days from the scheduled event, security staffing is not guaranteed. Contact David Cash, dcash@fit.edu, ext. 8176 with any questions.
Event cancellations with less than 24 hours’ notice may result in a cancellation fee of $100 or 10% of the security services cost estimate, whichever is less. In the event that you need to cancel
this event, please email dcash@fit.edu.
*Indicates required fields.
Date(s) of Event*
_____________________________________________________________________________________________________________________________________________________________________________
Name of Event* ______________________________________________________________________________________________________________________________________________________________________________
Synopsis of Event (please provide a description of event)* ________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________________________________________________________
Select the services you are requesting*
❏ Barricades ❏ Parking Control ❏ Site Security ❏ Training ❏ Traffic Control ❏ Venue Security
Location of Event
_____________________________________________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________________________________________________________
The event will be open to:*
❏ All faculty, staff and students ❏ Invitation only (includes off-campus guests) ❏ General public ❏ Other
Time Event Begins* ______________________________ Time Event Ends* ______________________________
Time security officers/personnel should be on site (if different than event start time) ______________________________
Will alcohol be served?
❏ Yes ❏ No ❏ N/A
Expected Attendance ______________________________
Requestor’s Name*
______________________________________________________________________________________________
First* Last*
Email* _________________________________________________________________________________________________________
Phone* _________________________________________________________________________________________________________
Name and phone number for person who will be on-site at the event* ______________________________________________________________________________________________________________________________
Will university staff be present at the event?*
❏ Yes ❏ No ❏ N/A
If “yes”, please list the university staff person’s name
_____________________________________________________________________________________________________________________________________________
Name of Florida Tech sponsoring group (please do not use acronyms)* ____________________________________________________________________________________________________________________________
Name of Florida Tech student or staff member responsible for this event* __________________________________________________________________________________________________________________________
Additional persons responsible for this event (please include cell phone number)____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________________________________________________________________________
Name of person financially responsible for this event* ____________________________________________________________________________________________________________________________________________
First* Last*
Phone number for person financially responsible* __________________________________________________________________
Email address for financially responsible person* ___________________________________________________________________
