Fireworks Display Approval Application

Fireworks Display Approval Application
Apply for permission to hold a fireworks display. Please provide complete event and safety details.
Applicant Full Name
First NameLast Name
Email Address
example@example.com
Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Organization Name (if applicable)
Event Location (address where the fireworks display will be held)
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Event Date and Time
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Type of Fireworks Display
Estimated Number of Attendees
Describe the safety measures and emergency plans for the event
Should be Empty: