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Event Registration Form

Applicable for Thomas Jefferson University and Hospitals in Center City

This Event Registration Form should be completed for all events occurring at Thomas Jefferson University and hospitals in the Center City location. Please complete and submit this form at least seven (7) business days in advance of the event.  To ensure the safety, security, and operational readiness of our campus, completion of a Public Safety Event Registration Form is required for all events hosted on Jefferson property, including meetings, conferences, guest speakers, and after-hours functions.

If you are requesting the presence of Jefferson Police or Security Officers at your event, Public Safety will determine the number that are needed based on the location, date, time and number of attendees.

Should you need Jefferson Police Department support, please email:

HH:MM:AM/PM
HH:MM:AM/PM
Approximate number of attendees that are both Jefferson and Non-Jefferson affiliated:
Name(s) of attendees that are both Jefferson and Non-Jefferson affiliated. Else indicate if list was email and date sent per following note.

If the attendee list is significant, whereby it exceeds the space allocated on this form, please email an Excel file to the following Public Safety personnel:
Michael.Spositi@jefferson.edu; Ryan.Walter@jefferson.edu

Do you need Jefferson Police Department (JPD) Services?
Are you requesting Jefferson un-sworn Security Officers at this Event?