1

Community/Group/Organization Name:

Community/Group/Organization Name:

2

Location of event: 

 *

Location of event:

3

Event start and end time:

Event start and end time:

4

What type of event are you hosting?

 *

What type of event are you hosting?

Meet and Greet in the Street

Cookout

Block Party

Ice Cream Social

Balloons on the mailbox

Banner

Other

5

Contact's name:

 *

Contact's name:

6

Contact's address: 

Contact's address:

7

Email:

Email:

8

Phone number: 

Phone number: ext.

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2. Email Address

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