Special Events / Street Closings Application - City of Martinsville, Indiana

Name of Event*

Sponsoring Organization*

Organization’s Address*

Street Address Address Line 2 City State ZIP Code

Date of Event:*

MM

DD

YYYY

End Date of Event:*

MM

DD

YYYY

Start and End Times*

Location of Event / Route*

Primary Contact Person*

Telephone*

Email Address*

Enter Email Confirm Email

Secondary Contact Person*

Telephone*

Email Address*

Enter Email Confirm Email

Event Description*

City Services Requested*

Streets to be Closed:

Street Name

Between (Street Name)

Street Name

Between (Street Name)

Street Name

Between (Street Name)

From (time of start of closure)

To (end time of closure)

Additional Information

This form must be submitted not less than 60 days in advance of the event.

If concessions or fund-raising activities are a part of this event, please check with the City Clerk-Treasurer’s office at 765-342-6012 regarding any necessary licensing; permits; and/or proofs of insurance.