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2. APPLICATION FOR USE OF FACILITY
4. Application to be submitted to the County Administrator's Office by e-mail, mail or in-person no later than 30 days prior to the event date requested. Submission of application does not guarantee approval for use of the facility.
6. TODAY'S DATE:
   TODAY'S DATE:

   TODAY'S DATE:
8. DATE(S)/TIME(S) OF EVENT:
   DATE(S)/TIME(S) OF EVENT:

   DATE(S)/TIME(S) OF EVENT:
9. DATE(S)/TIME(S) OF EVENT:
   DATE(S)/TIME(S) OF EVENT:

   DATE(S)/TIME(S) OF EVENT:
11. DETAIL DESCRIPTION OF EVENT (INCLUDING NUMBER OF PARTICIPANTS):
13. WILL ALCOHOL BE SERVED?

    1. YES

    1. NO
14. ARE KITCHEN APPLICANCES TO BE UTILIZED:

    1. YES

    1. NO
16. WHO WILL OBTAIN THE ABC PERMIT?
18. NAME OF PERSON/ORGANIZATION MAKING REQUEST:
20. TYPE OF ORGANIZATION:
22. CONTACT EMAIL ADDRESS
23. CONTACT PHONE NUMBER
25. CONTACT MAILING ADDRESS
27. CITY
28. STATE
29. ZIP CODE
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

* indicates a required field