{"id":1114,"date":"2024-12-02T19:24:42","date_gmt":"2024-12-03T01:24:42","guid":{"rendered":"https:\/\/coopertownpd.org\/cpdwp\/?page_id=1114"},"modified":"2025-03-13T10:06:12","modified_gmt":"2025-03-13T16:06:12","slug":"extra-patrol-request","status":"publish","type":"page","link":"https:\/\/coopertownpd.org\/cpdwp\/extra-patrol-request\/","title":{"rendered":"Extra Patrol Request"},"content":{"rendered":"\n<p>The Coopertown Police Department offers Extra Patrol to all citizens and businesses within the limits of the Town of Coopertown, Tennessee. Residents and businesses who want a police officer to patrol\u00a0their property more frequently because of a special circumstance or\u00a0issue could benefit from this service. After reading the information below, kindly fill out this form.<\/p>\n\n\n\n<div class=\"forminator-guttenberg\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-1111 forminator-design--default  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-1111\" data-uid=\"69e1123460e3e\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-1111\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-1111 forminator-design--default  forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"1111\"\n\t\t\t\t data-color-option=\"theme\" data-design=\"default\" data-grid=\"open\" style=\"display: none;\"\n\t\t\t\tdata-uid=\"69e1123460e3e\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"group-1\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">EMERGENCY NOTICE<\/label><span class=\"forminator-description forminator-repeater-description\">IF THIS REQUEST IS REGARDING AN EMERGENCY SITUATION THAT IMMEDIATELY THREATENS LIFE, LIMB, OR PROPERTY, STOP THIS REQUEST AND CALL 911 IMMEDIATELY!<\/span><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:false,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Add item&quot;,&quot;remove_text&quot;:&quot;Remove item&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"consent-1\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-1_69e1123460e3e\" id=\"forminator-field-consent-1_69e1123460e3e-label\" class=\"forminator-label\">This Request Is NOT An Emergency <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-1_69e1123460e3e__label\" class=\"forminator-checkbox forminator-consent\"><input type=\"checkbox\" name=\"consent-1\" id=\"forminator-field-consent-1_69e1123460e3e\" value=\"checked\" aria-labelledby=\"forminator-field-consent-1_69e1123460e3e-label\" aria-describedby=\"forminator-field-consent-1_69e1123460e3e__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-1_69e1123460e3e__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p><strong><span style=\"color: red\">By checking this box, I affirm this Extra Patrol Request is not related to an emergency situation that immediately threatens life, limb, or property. I understand that if it this was related to an emergency, I should stop this request and should immediately call 911.<\/span><\/strong><\/p><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-3\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">Internet Security<\/label><span class=\"forminator-description forminator-repeater-description\">Please read and acknowledge understanding<\/span><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:false,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Add item&quot;,&quot;remove_text&quot;:&quot;Remove item&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"consent-2\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-2_69e1123460e3e\" id=\"forminator-field-consent-2_69e1123460e3e-label\" class=\"forminator-label\">Security <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-2_69e1123460e3e__label\" class=\"forminator-checkbox forminator-consent\"><input type=\"checkbox\" name=\"consent-2\" id=\"forminator-field-consent-2_69e1123460e3e\" value=\"checked\" aria-labelledby=\"forminator-field-consent-2_69e1123460e3e-label\" aria-describedby=\"forminator-field-consent-2_69e1123460e3e__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-2_69e1123460e3e__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p>When submitting forms over the internet, there is always the risk that information provided can be viewed by someone else. The Coopertown Police Department takes normal precautions to protect data, and we only ask for the minimal information necessary to process your request. However, you are submitting this data with the understanding that we cannot guarantee this information will not be intercepted. If you do not prefer to submit this form online, you can visit us at 5153 Burgess Gower Rd, Coopertown, TN 37172 or call the police department at (615) 382-7007.<\/p><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-2\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">Requestor Information<\/label><span class=\"forminator-description forminator-repeater-description\">Please enter the name, e-mail address, and phone number of the person making the Extra Patrol Request.<\/span><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:false,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Add item&quot;,&quot;remove_text&quot;:&quot;Remove item&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_69e1123460e3e\" id=\"forminator-field-name-1_69e1123460e3e-label\" class=\"forminator-label\">Name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"Ex. John Doe\" id=\"forminator-field-name-1_69e1123460e3e\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" autocomplete=\"name\" aria-describedby=\"forminator-field-name-1_69e1123460e3e-description\" \/><span id=\"forminator-field-name-1_69e1123460e3e-description\" class=\"forminator-description\">Full name of person submitting this request<\/span><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_69e1123460e3e\" id=\"forminator-field-email-1_69e1123460e3e-label\" class=\"forminator-label\">Email Address <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"Ex. john@doe.com\" id=\"forminator-field-email-1_69e1123460e3e\" class=\"forminator-input forminator-email--field\" data-required=\"1\" aria-required=\"true\" autocomplete=\"email\" aria-describedby=\"forminator-field-email-1_69e1123460e3e-description\" \/><span id=\"forminator-field-email-1_69e1123460e3e-description\" class=\"forminator-description\">E-mail address of requestor<\/span><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_69e1123460e3e\" id=\"forminator-field-phone-1_69e1123460e3e-label\" class=\"forminator-label\">Phone <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"Ex. 615-382-7007\" id=\"forminator-field-phone-1_69e1123460e3e\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" data-national_mode=\"enabled\" data-country=\"us\" data-validation=\"standard\" aria-describedby=\"forminator-field-phone-1_69e1123460e3e-description\" \/><span id=\"forminator-field-phone-1_69e1123460e3e-description\" class=\"forminator-description\" id=\"forminator-field-phone-1_69e1123460e3e-description\">Phone number of requestor.<\/span><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-4\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">Location of Extra Patrol<\/label><span class=\"forminator-description forminator-repeater-description\">Describe the location, dates, and details of the extra patrol<\/span><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:false,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Add item&quot;,&quot;remove_text&quot;:&quot;Remove item&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"consent-3\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-3_69e1123460e3e\" id=\"forminator-field-consent-3_69e1123460e3e-label\" class=\"forminator-label\">Location Verification <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-3_69e1123460e3e__label\" class=\"forminator-checkbox forminator-consent\"><input type=\"checkbox\" name=\"consent-3\" id=\"forminator-field-consent-3_69e1123460e3e\" value=\"checked\" aria-labelledby=\"forminator-field-consent-3_69e1123460e3e-label\" aria-describedby=\"forminator-field-consent-3_69e1123460e3e__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-3_69e1123460e3e__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p><strong>Jurisdiction<\/strong><br>By checking, you are verifying that this address is located in the municipal limits of the Town of Coopertown and Coopertown Police Department officers patrol the area near your home or business.&nbsp;<\/p><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"address-1\" class=\"forminator-field-address forminator-col forminator-col-12 \"><div class=\"forminator-row\"><div id=\"address-1-street_address\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-street_address_69e1123460e3e\" id=\"forminator-field-address-1-street_address_69e1123460e3e-label\" class=\"forminator-label\">Street Address <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"address-1-street_address\" placeholder=\"Ex. 5153 Burgess Gower Rd\" id=\"forminator-field-address-1-street_address_69e1123460e3e\" class=\"forminator-input\" data-required=\"1\" aria-required=\"true\" autocomplete=\"address-line1\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"address-1-address_line\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-address_line_69e1123460e3e\" id=\"forminator-field-address-1-address_line_69e1123460e3e-label\" class=\"forminator-label\">Apartment, suite, etc<\/label><input type=\"text\" name=\"address-1-address_line\" placeholder=\"\" id=\"forminator-field-address-1-address_line_69e1123460e3e\" class=\"forminator-input\" data-required=\"\" aria-required=\"false\" autocomplete=\"address-line2\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\" data-multiple=\"true\"><div id=\"address-1-city\" class=\"forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-city_69e1123460e3e\" id=\"forminator-field-address-1-city_69e1123460e3e-label\" class=\"forminator-label\">City <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"address-1-city\" placeholder=\"Ex. Coopertown\" id=\"forminator-field-address-1-city_69e1123460e3e\" class=\"forminator-input\" data-required=\"1\" aria-required=\"true\" autocomplete=\"address-level2\" value=\"\" \/><\/div><\/div><div id=\"address-1-state\" class=\"forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-state_69e1123460e3e\" id=\"forminator-field-address-1-state_69e1123460e3e-label\" class=\"forminator-label\">State\/Province <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"address-1-state\" placeholder=\"Tennessee\" id=\"forminator-field-address-1-state_69e1123460e3e\" class=\"forminator-input\" data-required=\"1\" aria-required=\"true\" autocomplete=\"address-level1\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\" data-multiple=\"false\"><div id=\"address-1-zip\" class=\"forminator-col forminator-col-12\"><div class=\"forminator-field\"><label for=\"forminator-field-address-1-zip_69e1123460e3e\" id=\"forminator-field-address-1-zip_69e1123460e3e-label\" class=\"forminator-label\">ZIP \/ Postal Code <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"address-1-zip\" placeholder=\"Ex. 37172\" id=\"forminator-field-address-1-zip_69e1123460e3e\" class=\"forminator-input\" autocomplete=\"postal-code\" value=\"\" \/><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-1\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-1_69e1123460e3e\" id=\"forminator-field-textarea-1_69e1123460e3e-label\" class=\"forminator-label\">Details <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-1\" placeholder=\"\" id=\"forminator-field-textarea-1_69e1123460e3e\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" aria-describedby=\"forminator-field-textarea-1_69e1123460e3e-description\" ><\/textarea><span id=\"forminator-field-textarea-1_69e1123460e3e-description\" class=\"forminator-description\">Please list any pertinent information regarding the Extra Patrol Request (ex. will any lights be left on, what vehicles left in driveway, etc)<\/span><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-1\" class=\"forminator-field-date forminator-col forminator-col-12 \"><label for=\"forminator-field-date-1\" id=\"forminator-field-date-1-label\" class=\"forminator-label\">Start Date <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-date-select\"><div class=\"forminator-row\" data-multiple=\"true\"><div id=\"date-1-month\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-1111__field--date-1-month_69e1123460e3e\" id=\"forminator-field-1111__field--date-1-month_69e1123460e3e-label\" class=\"forminator-label\">Start Month<\/label><select name=\"date-1-month\" id=\"forminator-field-1111__field--date-1-month_69e1123460e3e\" class=\"forminator-select2\" data-format=\"mm\/dd\/yy\" data-parent=\"date-1\" aria-labelledby=\"forminator-field-1111__field--date-1-month_69e1123460e3e-label\" data-default-value=\"\"><option value=\"\" selected=\"selected\">Select month<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><\/select><\/div><\/div><div id=\"date-1-day\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-1111__field--date-1-day_69e1123460e3e\" id=\"forminator-field-1111__field--date-1-day_69e1123460e3e-label\" class=\"forminator-label\">Start Day<\/label><select name=\"date-1-day\" id=\"forminator-field-1111__field--date-1-day_69e1123460e3e\" class=\"forminator-select2\" data-format=\"mm\/dd\/yy\" data-parent=\"date-1\" aria-labelledby=\"forminator-field-1111__field--date-1-day_69e1123460e3e-label\" data-default-value=\"\"><option value=\"\" selected=\"selected\">Select day<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><option value=\"13\" >13<\/option><option value=\"14\" >14<\/option><option value=\"15\" >15<\/option><option value=\"16\" >16<\/option><option value=\"17\" >17<\/option><option value=\"18\" >18<\/option><option value=\"19\" >19<\/option><option value=\"20\" >20<\/option><option value=\"21\" >21<\/option><option value=\"22\" >22<\/option><option value=\"23\" >23<\/option><option value=\"24\" >24<\/option><option value=\"25\" >25<\/option><option value=\"26\" >26<\/option><option value=\"27\" >27<\/option><option value=\"28\" >28<\/option><option value=\"29\" >29<\/option><option value=\"30\" >30<\/option><option value=\"31\" >31<\/option><\/select><\/div><\/div><div id=\"date-1-year\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-1111__field--date-1-year_69e1123460e3e\" id=\"forminator-field-1111__field--date-1-year_69e1123460e3e-label\" class=\"forminator-label\">Start Year<\/label><select name=\"date-1-year\" id=\"forminator-field-1111__field--date-1-year_69e1123460e3e\" class=\"forminator-select2\" data-format=\"mm\/dd\/yy\" data-parent=\"date-1\" aria-labelledby=\"forminator-field-1111__field--date-1-year_69e1123460e3e-label\" data-default-value=\"\"><option value=\"\" selected=\"selected\">Select Year<\/option><option value=\"2050\" >2050<\/option><option value=\"2049\" >2049<\/option><option value=\"2048\" >2048<\/option><option value=\"2047\" >2047<\/option><option value=\"2046\" >2046<\/option><option value=\"2045\" >2045<\/option><option value=\"2044\" >2044<\/option><option value=\"2043\" >2043<\/option><option value=\"2042\" >2042<\/option><option value=\"2041\" >2041<\/option><option value=\"2040\" >2040<\/option><option value=\"2039\" >2039<\/option><option value=\"2038\" >2038<\/option><option value=\"2037\" >2037<\/option><option value=\"2036\" >2036<\/option><option value=\"2035\" >2035<\/option><option value=\"2034\" >2034<\/option><option value=\"2033\" >2033<\/option><option value=\"2032\" >2032<\/option><option value=\"2031\" >2031<\/option><option value=\"2030\" >2030<\/option><option value=\"2029\" >2029<\/option><option value=\"2028\" >2028<\/option><option value=\"2027\" >2027<\/option><option value=\"2026\" >2026<\/option><option value=\"2025\" >2025<\/option><option value=\"2024\" >2024<\/option><\/select><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-2\" class=\"forminator-field-date forminator-col forminator-col-12 \"><label for=\"forminator-field-date-2\" id=\"forminator-field-date-2-label\" class=\"forminator-label\">End Date <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-date-select\"><div class=\"forminator-row\" data-multiple=\"true\"><div id=\"date-2-month\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-1111__field--date-2-month_69e1123460e3e\" id=\"forminator-field-1111__field--date-2-month_69e1123460e3e-label\" class=\"forminator-label\">End Month<\/label><select name=\"date-2-month\" id=\"forminator-field-1111__field--date-2-month_69e1123460e3e\" class=\"forminator-select2\" data-format=\"mm\/dd\/yy\" data-parent=\"date-2\" aria-labelledby=\"forminator-field-1111__field--date-2-month_69e1123460e3e-label\" data-default-value=\"\"><option value=\"\" selected=\"selected\">Select month<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><\/select><\/div><\/div><div id=\"date-2-day\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-1111__field--date-2-day_69e1123460e3e\" id=\"forminator-field-1111__field--date-2-day_69e1123460e3e-label\" class=\"forminator-label\">End Day<\/label><select name=\"date-2-day\" id=\"forminator-field-1111__field--date-2-day_69e1123460e3e\" class=\"forminator-select2\" data-format=\"mm\/dd\/yy\" data-parent=\"date-2\" aria-labelledby=\"forminator-field-1111__field--date-2-day_69e1123460e3e-label\" data-default-value=\"\"><option value=\"\" selected=\"selected\">Select day<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><option value=\"13\" >13<\/option><option value=\"14\" >14<\/option><option value=\"15\" >15<\/option><option value=\"16\" >16<\/option><option value=\"17\" >17<\/option><option value=\"18\" >18<\/option><option value=\"19\" >19<\/option><option value=\"20\" >20<\/option><option value=\"21\" >21<\/option><option value=\"22\" >22<\/option><option value=\"23\" >23<\/option><option value=\"24\" >24<\/option><option value=\"25\" >25<\/option><option value=\"26\" >26<\/option><option value=\"27\" >27<\/option><option value=\"28\" >28<\/option><option value=\"29\" >29<\/option><option value=\"30\" >30<\/option><option value=\"31\" >31<\/option><\/select><\/div><\/div><div id=\"date-2-year\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-1111__field--date-2-year_69e1123460e3e\" id=\"forminator-field-1111__field--date-2-year_69e1123460e3e-label\" class=\"forminator-label\">End Year<\/label><select name=\"date-2-year\" id=\"forminator-field-1111__field--date-2-year_69e1123460e3e\" class=\"forminator-select2\" data-format=\"mm\/dd\/yy\" data-parent=\"date-2\" aria-labelledby=\"forminator-field-1111__field--date-2-year_69e1123460e3e-label\" data-default-value=\"\"><option value=\"\" selected=\"selected\">Select Year<\/option><option value=\"2050\" >2050<\/option><option value=\"2049\" >2049<\/option><option value=\"2048\" >2048<\/option><option value=\"2047\" >2047<\/option><option value=\"2046\" >2046<\/option><option value=\"2045\" >2045<\/option><option value=\"2044\" >2044<\/option><option value=\"2043\" >2043<\/option><option value=\"2042\" >2042<\/option><option value=\"2041\" >2041<\/option><option value=\"2040\" >2040<\/option><option value=\"2039\" >2039<\/option><option value=\"2038\" >2038<\/option><option value=\"2037\" >2037<\/option><option value=\"2036\" >2036<\/option><option value=\"2035\" >2035<\/option><option value=\"2034\" >2034<\/option><option value=\"2033\" >2033<\/option><option value=\"2032\" >2032<\/option><option value=\"2031\" >2031<\/option><option value=\"2030\" >2030<\/option><option value=\"2029\" >2029<\/option><option value=\"2028\" >2028<\/option><option value=\"2027\" >2027<\/option><option value=\"2026\" >2026<\/option><option value=\"2025\" >2025<\/option><option value=\"2024\" >2024<\/option><\/select><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-5\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">Liability and Understanding Agreements<\/label><span class=\"forminator-description forminator-repeater-description\">Please read and acknowledge<\/span><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:false,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Add item&quot;,&quot;remove_text&quot;:&quot;Remove item&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"consent-4\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-4_69e1123460e3e\" id=\"forminator-field-consent-4_69e1123460e3e-label\" class=\"forminator-label\">Liability Agreement <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-4_69e1123460e3e__label\" class=\"forminator-checkbox forminator-consent\"><input type=\"checkbox\" name=\"consent-4\" id=\"forminator-field-consent-4_69e1123460e3e\" value=\"checked\" aria-labelledby=\"forminator-field-consent-4_69e1123460e3e-label\" aria-describedby=\"forminator-field-consent-4_69e1123460e3e__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-4_69e1123460e3e__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p>Please read the following statement before submitting this form. The Coopertown Police Department, per your request, will attempt to check your residence periodically. Neither the Town of Coopertown, Tennessee, nor the Coopertown Police Department, assumes any liability in the event of theft, loss or damage to personal or real property in or around your residence. By submitting this form, it is understood and agreed neither the Town of Coopertown, Tennessee, nor the Coopertown Police Department, assumes any liability with the \"Extra Patrol Request.\" The resident, by accepting the \"Extra Patrol Request,\" and by execution of this request understands and agrees to the provisions of this release.<\/p><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"consent-5\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-5_69e1123460e3e\" id=\"forminator-field-consent-5_69e1123460e3e-label\" class=\"forminator-label\">Personal Liability <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-5_69e1123460e3e__label\" class=\"forminator-checkbox forminator-consent\"><input type=\"checkbox\" name=\"consent-5\" id=\"forminator-field-consent-5_69e1123460e3e\" value=\"checked\" aria-labelledby=\"forminator-field-consent-5_69e1123460e3e-label\" aria-describedby=\"forminator-field-consent-5_69e1123460e3e__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-5_69e1123460e3e__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p>The Coopertown Police Department makes every effort to check every security check request we have on file. However, due to our response to other calls for service, we cannot guarantee the security of your property on an individual basis. If you are going to be away, you should take every precaution to secure your property in your absence.<\/p><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"consent-6\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-6_69e1123460e3e\" id=\"forminator-field-consent-6_69e1123460e3e-label\" class=\"forminator-label\">Understanding Agreement <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-6_69e1123460e3e__label\" class=\"forminator-checkbox forminator-consent\"><input type=\"checkbox\" name=\"consent-6\" id=\"forminator-field-consent-6_69e1123460e3e\" value=\"checked\" aria-labelledby=\"forminator-field-consent-6_69e1123460e3e-label\" aria-describedby=\"forminator-field-consent-6_69e1123460e3e__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-6_69e1123460e3e__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p>I certify that I am the owner or caretaker of the property described above, and that the information provided is to the best of my knowledge. I further understand this information is being transmitted over the internet and could be subject to interception by third parties and could be delayed or not delivered due to technical errors. I further understand that the Coopertown Police Department may make reasonable efforts to fulfill this Extra Patrol Request, but cannot guarantee my property will be checked with regularity, if at all, under this program due the possibility that higher priority requests for service could interfere.<\/p><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\">Send Message<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"f002d7d14f\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/cpdwp\/wp-json\/wp\/v2\/pages\/1114\" \/><input type=\"hidden\" name=\"form_id\" value=\"1111\"><input type=\"hidden\" name=\"page_id\" value=\"1114\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/coopertownpd.org\/cpdwp\/extra-patrol-request\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><label for=\"input_19\" class=\"forminator-hidden\" aria-hidden=\"true\">Please do not fill in this field. <input id=\"input_19\" type=\"text\" name=\"input_19\" value=\"\" autocomplete=\"off\"><\/label><\/form><\/div>\n","protected":false},"excerpt":{"rendered":"<p>The Coopertown Police Department offers Extra Patrol to all citizens and businesses within the limits of the Town of Coopertown,&hellip;<\/p>\n","protected":false},"author":1,"featured_media":1116,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_price":"","_stock":"","_tribe_ticket_header":"","_tribe_default_ticket_provider":"","_tribe_ticket_capacity":"0","_ticket_start_date":"","_ticket_end_date":"","_tribe_ticket_show_description":"","_tribe_ticket_show_not_going":false,"_tribe_ticket_use_global_stock":"","_tribe_ticket_global_stock_level":"","_global_stock_mode":"","_global_stock_cap":"","_tribe_rsvp_for_event":"","_tribe_ticket_going_count":"","_tribe_ticket_not_going_count":"","_tribe_tickets_list":"[]","_tribe_ticket_has_attendee_info_fields":false,"footnotes":"","_tec_slr_enabled":"","_tec_slr_layout":""},"class_list":["post-1114","page","type-page","status-publish","has-post-thumbnail","hentry"],"aioseo_notices":[],"jetpack_sharing_enabled":true,"ticketed":false,"_links":{"self":[{"href":"https:\/\/coopertownpd.org\/cpdwp\/wp-json\/wp\/v2\/pages\/1114","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/coopertownpd.org\/cpdwp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/coopertownpd.org\/cpdwp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/coopertownpd.org\/cpdwp\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/coopertownpd.org\/cpdwp\/wp-json\/wp\/v2\/comments?post=1114"}],"version-history":[{"count":2,"href":"https:\/\/coopertownpd.org\/cpdwp\/wp-json\/wp\/v2\/pages\/1114\/revisions"}],"predecessor-version":[{"id":1144,"href":"https:\/\/coopertownpd.org\/cpdwp\/wp-json\/wp\/v2\/pages\/1114\/revisions\/1144"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/coopertownpd.org\/cpdwp\/wp-json\/wp\/v2\/media\/1116"}],"wp:attachment":[{"href":"https:\/\/coopertownpd.org\/cpdwp\/wp-json\/wp\/v2\/media?parent=1114"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}