Special Event Application

Applicant Information First Name: * Last Name: * Email: * Business Phone Number: Cell Phone Number: Organization Information Promoter/Organization/Company Name: * Street Address: * City: * State: Please Select Armed Forces Americas Armed Forces Europe Armed Forces Canada Armed Forces Africa Armed Forces Middle East Armed Forces Pacific Alabama Alaska American Samoa Arizona Arkansas California Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Palua Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming * Zip Code: * Second Point of Contact Information Is there a Second Point of Contact?* YesNo Second Point of Contact Name: Phone: Email: Event Information Name of Event: * Is this your first time hosting this event? YesNo Name & Address of venue where your event will be held: * Date of Event: Month:Day:Year:* Time of Event: Please Select AM PM * Number of Attendees: * Event Category (Please check all that apply)* Athletic or RecreationConcert or PerformanceCircusExhibitsFarmers' or Outdoor MarketCarnival Festival or CelebrationMuseum or Special AttractionDanceParade/MarchOther Will food be provided or sold at your event?* YesNo Will alcohol be allowed, provided and/or sold at your event?* YesNo Insurance Do you have a Certificate of Insurance?* Policy Amount: YesNo Temporary Structures Will the event require temporary structures? (e.g., tents, stages)* Will the event include inflatables?* YesNo YesNo Additional Information Required Please provide a brief description of your event and any online links available for the event.* Have you consulted with any agencies so far? (If yes, please list the agency name and contact information) Do you have any final comments? * - identifies required fields.