[City of Gastonia] Special Event Application

Are you a non-profit organization requesting in-kind services?

Yes

Event Date

Month

Day

Year

Applicant Information

Full Name of Applicant

First Name

Last Name

Full Address

Street Address

City

State

Zip

Organization Sponsoring Event

Type of Organization

Non-Profit

Public Agency

For-Profit Business

N/A- Personal Use

Non-Profit Organization Information Required

Name of Organization

Organization Address

Street Address

City

State

Zip

Organization Phone Number

Are you requesting in-kind services?

Yes

What type of in-kind services is your organization requesting? (check all that apply) (As mentioned on the application, the IKS requests go through an approval process. The approval is not a guarantee.)

Police (Security)

Fire/Emergency Medical

Clean up/Sanitation

Electrical Hookups

Street Closure

Describe the event for which services are being requested and specifically how each of the in-kind services requested will be used.

Please describe why police are needed for the event and any public safety issues that have a potential to occur at this event.

How many officers are you looking at having for the event?

Please describe what your expectations are for the Police Department to do/provide.

Security

Traffic Direction

Traffic Cones/Barricades

Leading a parade/run

Has your organization received in-kind services from the City of Gastonia within the last 24 months?

Yes

Please describe the event, date, and type of services received.

Describe the mission of your organization:

Describe the target population being served by your organization:

What is the number of clients served annually by your organization?

Special Event Details

Type of Event

Description of Event

On-Site Contact Name

On-Site Contact Cell Phone Number

How many organization representatives will you have on-site during the event? (Specify between paid staff and volunteers)

Is the event taking place over more than one day?

Yes

Please list all event dates

What time will set up begin and break down end?

Number of Guests Anticipated

Will the event take place on city property?

Yes

Park and Center Information

Use of Facilities Information

What park will the event be taking place at?

Memorial Hall

Rotary Centennial Pavilion

Other

Event Address

Street Address

City

State

Zip

Event Address

Street Address

City

State

Zip

Special Consideration (Check all that apply)

How will food be served? (Check all that apply)

Packaged food will be sold

Food will be cooked/grilled off-site and served

Food will be cooked/grilled in food truck and served

Food will be cooked/grilled in food truck and sold

Have you ever been cited with any violation of Gastonia's noise ordinance within the last year?

Yes, I have been cited

No, I have not been cited

Please explain violation

Please explain what type of amplified sound the event will have? (DJ, performers, etc.)

Street Closure Information

Name of street and portion to be closed

How are you planning on closing the street?

What portion of sidewalk will be closed? (along which street, between what buildings, etc)

The event will generate no significant complaints from the public regarding noise, glare, traffic, odor, or other public nuisance.

Yes

The City of Gastonia expects all events to be litter-free. Describe your clean-up plans during and after the event.

Is the event a fundraiser?

Yes

What will the funds be used for?

Will you be charging an admission fee for the event?

Yes

What is the admission fee?

Will the event be open to the public?

Yes

Will the event be advertised?

Yes

Please give a description of advertising used:

Is there an outside event promoter associated with the event?

Yes

Please provide the name of the promoter and contact information:

Please list any other organizations or individuals involved in or sponsoring this event:

Please list all sources of funding received and requested for this event (admission or entry fees, donations, grants, etc):

What benefit will the City of Gastonia receive from this event?

Other Pertinent Information:

Site Map Information

Upload File(s)- Site Map

Click Here to Upload

Upload File(s)- Certificate of Insurance

Click Here to Upload

Upload File(s)- Organizational Documents (Articles of Incorporation) and Proof of Non-Profit Status or 501(c)(3)

Click Here to Upload

Upload File(s)- Budget

Click Here to Upload

Upload File(s)- Current Board Member Roster

Click Here to Upload

Applicant- Sign Here

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.