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Neighbourhood Block Party Application Form

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Name of neighbourhood group:

Name of Primary Contact:

Complete Mailing Address:

Postal Code:

Telephone:

Enter a valid phone number. Example: 123-456-7890

E-mail Address:

Name of Secondary Contact:

Complete Mailing Address:

Postal Code:

Telephone:

Enter a valid phone number. Example: 123-456-7890

Date of event:

Start time:

End time:

Location of event:

Rain date:

:

Materials Requested:

Garbage Cans - Number Requested:

Picnic Tables - Number Requested:

Flyers - Number Requested:

Please attach draft copy of flyer if required.

Please provide any additional information required you feel may be necessary: