Community Services Request Form

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

No

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

Additional Notes, Equipment, or Special Requests:*

Requesting Person or Organization*

Address*

Contact Person*

Phone*

Email*