Community Services Request Form

Event Information

Name of Event *

Type of Event *

Other *

Date *

Start Time *

End Time *

Location *

Purpose of Event *

Projected Number of Attendees *

Permit Required *

Permit Obtained *

List Permits (If Applicable) *

Stationary Event *

Yes

If no, provide start and end locations (attach map for reference) *

Additional Notes, Equipment, or Special Requests: *

Requesting Person or Organization *

Address *

Address line 2

City *

State *

ZIP Code *

Contact Person *

Phone *

Email *