Randolph Civic Foundation Block Party Sponsorship Request
Please complete the following for
Requestor's Name
Requestor's Phone Number
Requestor's Email Address
Requestor's Address
Date of planned event
MM
/
DD
/
YYYY
Do you plan to close blocks for your event?
Clear selection
If yes, which blocks?
Have you obtained approval from other households on your block?
Clear selection
Please describe your plans for the block party (activities, food, etc)
How many attendees do you anticipate at your event?
How many other households are assisting in the planning of the event?
By entering my name below, I hereby certify that the information contained within this application is truthful to the best of my knowledge. I further certify that I will obtain a county permit for the proposed block party and abide by the rules therein. I understand that, if my request is approved, the Randolph Civic Foundation will reimburse participants in the proposed block party up to a total of $150 for food, non-alcoholic beverages and entertainment, and that I will not receive reimbursement until I provide receipts. I certify that funds obtained through this request will be used for the stated lawful purposes. *
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