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Requests for Project ChildSafe safety kits should be made only by law enforcement partners. Individuals, community groups and businesses are encouraged to partner with a participating law enforcement agency. If the agency in your area is not a participating partner, please ask them to contact Project ChildSafe for more information.

FirstName *

 
LastName *:
Title:
L.E. Agency:
Org. Phone#:
My Phone#:
(Business Address - No Residential addresses)
Address:
Address2:
City:
State:
Zip:
Email: *
WebSite:
Comments and/or number of safety kits requested:

In order to submit this form, please type the color of the gun lock in the picture:

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