Carnival Permit Application

Applicant type

Corporation

Partnership

Individual

Legal name of business

Business phone

Business fax

Address of business

Applicant name

Title

Applicant address

Applicant phone

Applicant cell phone

Applicant email address

Location/address where carnival will be operated

Dates of carnival operation: start

Dates of carnival operation: close

Estimated total number of employees during event

Number of fingerprint background checks completed

Applicant signature

Signature date

Certification

I certify that the information provided in this application is complete and accurate.

Notary public name

Signed and sworn before notary on