Applicant Information

Name

Business Name

Mailing Address

City, State, Zip

Business Phone #

Business Fax#

Applicant Email

Event Information

Event Name

Event Location

Event Address

Contact Name

Contact Phone #

Contact Cell Phone #

Estimated Number of People in Attendance

Per day

Total

Event Date(s)

Start

End

Type of Event (check all that apply)

Nature of Event*

Athletic/Sporting Event Carival/Fair/Circus Concert/Music Festival Exhibit/Trade Show

Fireworks Motor Sport Political Rally Parade

Venue*

Indoors Outdoors

Tent(s)

Seating*

Festival Seating (no chairs) Fixed Seating/Chairs

Table Seating

Special Effects

Pyrotechnic Display Lasers

Open Flames Theatrical Fog/Smoke

Attachments

Site Plan Floor Plan

Seating Chart Pyrotechnics Permit

Attach File (if applicable)

Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)

Safety Precautions

Security

In-House Trained Crowd Managers

Private Security Law Enforcement

Emergency Medical

Basic First Aid Basic Life Support

Advanced Life Support None

Fire Protection

Fire Extinguishers Fire Sprinklers

Fire Watch Fire Department Detail