2. Name of Organization*
4. Name of Person Applying
6. Status?

   1. For Profit
   2. Non-Profit 501(c)(3)
   3. Other Non-Profit
8. Address
10. City
11. State
12. Zip Code
14. Mailing Address (If different)
16. City
17. State
18. Zip Code
20. Phone Number
21. Fax Number
23. Email Address
25. Event Date & Time
    Event Date & Time Start Date

    Event Date & Time Start Time

    —

    Event Date & Time End Date

    Event Date & Time End Time
26. Size of Group?
    Room capacity: 205 seated/400 standing
28. Description of Event
29. Food/beverages - describe
31. Alcohol?

    1. Beer
    2. Wine
    3. Neither
32. One-Day License Application Received?

    1. Yes
    2. No
33. Equipment needed?

    1. Podium
    2. Tables
    3. Other?
34. Describe Other
36. Equipment to be brought in? Please list:
37. Other Requests, Comments, info. Etc
39. Person Responsible- Name & Title
40. Email Address
42. Address
44. City
45. State
46. Zip Code
48. Phone Number
49. Fax Number
51. Read & Agree
    Town Hall Building Rules & Regulations
53. I AFFIRM THAT I HAVE READ THE ABOVE RULES AND REGULATIONS AND USE POLICY AND AGREE TO THESE TERMS.*

    1. Agree
55. Enter Full Name as Signature
Leave This Blank:


57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit

* indicates a required field