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2. Applicant Name*
3. Applicant Phone Number*
5. Applicant Street Address*
7. City*
8. State*
9. Zip Code*
11. Chairperson (if not applicant)
12. Chairperson Phone Number
14. Organization
15. Organization Phone Number
17. Organization Address
19. City
20. State
21. Zip Code
23. Is this event for profit?*

    1. Yes

    1. No
24. Amount of any entrance fee*
26. Date of Activity*
    Date of Activity
27. Start Time and End Time*
    Start Time and End Time Start Time

    —

    Start Time and End Time End Time
29. If more than 1 day, please indicate date range
    If more than 1 day, please indicate date range Start Date

    —

    If more than 1 day, please indicate date range End Date
31. Number of Vehicles Expected*
32. Number of Persons Expected to Attend*
34. Location and/or portion of public way to be occupied (attach sketch if necessary)*
    Please include specific address(es), as applicable.
36. Optional Sketch Attachment
38. Purpose of Event*
40. Request Use of Town Barricades*

    1. Yes

    1. No
41. Request Police Assistance*

    1. Yes

    1. No
43. Amplified Sound*

    1. Yes

    1. No

    If there will be Amplified Sound, a permit must be obtained from the Normal Police Department.
44. Have all persons abutting said street been notified of this activity*

    1. Yes

    1. No
46. The foregoing statements are true based on my best information and belief.
48. Applicant's Signature*
    By typing my name, I am electronically signing this application.
49. Date *
    Date
Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field