Community Services Request Form

Event Information

Name of Event * (required)

Type of Event * (required)

Other * (required)

Date * (required)

Start Time * (required)

End Time * (required)

Location * (required)

Purpose of Event * (required)

Projected Number of Attendees * (required)

Permit Required * (required)

Permit Obtained * (required)

List Permits (If Applicable) * (required)

Stationary Event * (required)

Yes

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

Additional Notes, Equipment, or Special Requests: * (required)

Requesting Person or Organization * (required)

Address * (required)

Address line 2

City * (required)

State * (required)

ZIP Code * (required)

Contact Person * (required)

Phone * (required)

Email * (required)