Name *

First Name

Last Name

Applicant Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Applicant Phone *

(###)

###

####

Parade/Event Chairman Name (Person responsible for the parade's conduct) *

First Name

Last Name

Parade/Event Chairman Phone Number *

First Name

Last Name

Parade/Event Chairman Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Organization Name

If Applicable

First Name

Last Name

Organization Headquarters Address

If Applicable

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Authorized/Responsible Head(s)

Name and Title

First Name

Last Name

Proposed Date of Parade/Event *

MM

DD

YYYY

Start Time *

Hour

Minute

Second

AM PM

End Time *

Hour

Minute

Second

AM PM

Assembly Start Time *

Time units begin to gather.

Hour

Minute

Second

AM PM

Interval of Space Between Units

First Name

Last Name

Check ONLY if Applicable:

The parade is designed to be held by and on behalf of, or for, a person/organization other than the applicant named in Section 1.

SIGNATURE AND ATTESTATION *

I affirm that the information provided above is true and accurate. I understand that the Chief of Police may require additional information necessary for a fair determination, and that I must comply with all local ordinances, including the prohibited hours of 6:00 p.m. to 6:00 a.m.

Yes

No