G.A.I.N. Registration Form

Deadline to register your G.A.I.N. Party is Friday, October 19. If you register after this date, there is no guarantee that you will be placed on the visitation list. Any questions about your G.A.I.N. party should be directed to your crime prevention officer. 

You must be an active block watch to receive a speciality unit visit. If you are having a party on November 3, 2012, use this form to register your G.A.I.N. party with the Mesa Police Department. Please list contact information for only one organizer. If there are co-organizers, please list one person as the contact. You may list the other person's info in the 'description of activities' section.  If you are combining your party with other streets that are also neighborhood watch groups, please fill out one registration form for all streets that are participating to avoid duplication of party entries.

** We have found that some have tried to submit this form using their tablet and we have not received it. If you are using your tablet to submit this form, please call 480-644-5008 to verify receipt. ** 

MY NEIGHBORHOOD OR COMMUNITY IS A/AN (choose one):

BLOCK CAPTAIN or PARTY ORGANIZER NAME  (please list one name only)

PARTY ORGANIZER NAME (if different from Captain listed above)

ORGANIZER PHONE NUMBER

ORGANIZER EMAIL

ORGANIZER ADDRESS

ZIP

PARTY LOCATION (list address if different than above)

PLEASE PROVIDE A CONTACT NAME & PHONE NUMBER FOR THE EVENING OF YOUR PARTY

THIS LOCATION IS A (choose one):

MAJOR CROSS STREETS   (i.e. Val Vista/University,  Sossaman/Baseline, etc.)

GATE CODE, IF YOUR PARTY LOCATION IS GATED

START AND END TIMES OF YOUR EVENT (must be a minimum of two hours between 4pm and 9pm)

ESTIMATE NUMBER OF ADULTS ATTENDING

ESTIMATE NUMBER OF CHILDREN ATTENDING

BRIEF DESCRIPTION OF ACTIVITIES PLANNED & ANY ADDITIONAL CAPTAIN/COORDINATOR NAMES

Please do not request specialty units. We understand that everyone would like to have McGruff, a fire truck, K-9 Unit, etc. visit their party. Visits are scheduled based on who is participating, how many parties are registered, their locations and party times.

Upon submittal of this form, you will receive a "thank you" response.