First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Cellular Phone
FAX
E-mail

          Primary Contact  (mandatory)

First Name
Last Name
Rank
Organization
Work Phone
E-mail

          Team Captain   (optional)

First Name
Last Name
Rank
Organization
Work Phone
Cellular Phone
E-mail

          Team Coach    (optional)

        Swat Team members Names and Rank (min 8 max10)

Name
Rank

          Swat Team member Name and Rank

Name
Rank

          SSwat Team member Name and Rank

Name
Rank

          Swat Team member Name and Rank

Name
Rank

          Swat Team member Name and Rank

Name
Rank

          Swat Team member Name and Rank

Name
Rank

          Swat Team member Name and Rank

Name
Rank

         Swat Team member Name and Rank

         Swat Team member Name and Rank

         Swat Team member Name and Rank

       Number of T-shirts and sizes needed  ( 1 T-shirt per participating operator)           

                       Sm 0 1 2 3 4 5 6 7 8 9 10     Med 0 1 2 3 4 5 6 7 8 9 10     Lrg 0 1 2 3 4 5 6 7 8 9 10     Xlrg 0 1 2 3 4 5 6 7 8 9 10

       Total number of sworn members in your department.

          

Questions/Comments

         

Send checks to:

The West Hartford Police Department                                                 Make Checks Payable to:          

 Attn: Lt. Don Melanson                                                                       West Hartford Swat

 103 Raymond Rd.                                                                               for the amount of $250

 West Hartford, Ct 06107