Special Event Permit Application PLEASE PRINT WITH BLACK INK – COMPLETE ALLSECTIONS AND SIGN APPLICATION
SECTION 1 – EVENT GENERAL INFORMATION LOCATION OF EVENT: EVENT NAME: EVENT DESCRIPTION: EVENT TYPE □ Athletic/Recreation □ Exhibits/Arts/Crafts □ Festivals/Celebration □ Parade/Run/Walk
□ Concert/Performance □ Church or Company Picnic □ Fund Raiser □ Subdivision Block Party
HAVE YOU HAD THIS EVENT BEFORE: □ Yes □ No APPLICANT NAME (Print): PHONE #: CELL #: APPLICANT ADDRESS:
ANNUAL EVENT: □ Yes □ No
FAX #:
SPONSORING ORGANIZATION: PERSON IN CHARGE: PERSON IN CHARGE ADDRESS:
□ Sales Event □ Circus □ Fair/Carnival □ Other
DATE OF APPLICATION: EMAIL:
PHONE #:
SPONSORING ORGANIZATION: □ NOT-FOR-PROFIT (NFP) PARTICIPANTS/VENDERS; □ NOT-FOR-PROFIT (NFP)
CELL #:
□ FOR-PROFIT (FP) □ FOR-PROFIT (FP)
MANAGER ON-SITE DAY OF EVENT:
CELL #:
SET UP DATE(S)/TIME(S):
TAKE DOWN DATE(S)/TIME(S):
REQUESTED DATE(S) OF OPERATION:
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THROUGH
HOURS OF OPERATION (indicate hours and circle am or pm): Sun am/pm to am/pm Mon Tues am/pm to am/pm Wed Thurs am/pm to am/pm Fri Sat am/pm to am/pm ESTIMATED PARTICIPANTS/WORKERS: ADVERTISING: □ Yes □ No
□ BOTH (NFP & FP)
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am/pm to am/pm to am/pm to
/
am/pm am/pm am/pm
ESTIMATED ATTENDANCE:
TYPE: □ Signs □ Newspaper □ Radio □ Television □ Other: