LBCC Public Safety Office Service Request
For Emergency Response or an immediate need, call the Security Office,
X4440 or the on-duty officer directly @ (541) 926-6855.
For all other requests, please use this form.
Ensure you scroll completely to the bottom of the form and press "submit" after filling in the boxes/fields for your request to be processed.
Requestor's First Name *
Your answer
Requestor's Last Name *
Your answer
Work Phone *
Your answer
Email Address *
Your answer
ExtService Requested: *
Required
Date Service is Requested *
Format: MM/DD/YY
Your answer
Time Service is to be Performed *
Format: HH:MM AM or PM
Your answer
Location Service is to be Performed *
Format: Building and Room # (e.g. RCH 119) or Lot # (e.g. Lot #4). If other than main campus, start with center designation)
Your answer
Person to be Met (if any)
Your answer
Additional Information
Your answer
Additional Day/Time Needed for this service
Format: MM/DD/YY; HH:MM Am or PM
Your answer
Additional Day/Time Needed for this service
Format: MM/DD/YY; HH:MM Am or PM
Your answer
Additional Day/Time Needed for this service
Format: MM/DD/YY; HH:MM Am or PM
Your answer
Additional Day/Time Needed for this service
Format: MM/DD/YY; HH:MM Am or PM
Your answer
Additional Day/Time Needed for this service
Format: MM/DD/YY; HH:MM Am or PM
Your answer
Additional Day/Time Needed for this service
Format: MM/DD/YY; HH:MM Am or PM
Your answer
Submit
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