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APPLICATION FOR CHARITABLE SOLICITATION ON THE RIGHT-OF-WAY
     
 
 
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Organization / Individual InformationPlease select who is applying for this permit:
 
Name of Organization/Individual: Individual DOB: Organization FL Registration
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Jacksonville Address:Contact Name: Contact Number: Contact Email: Charitable Solicitation will Benefit (Organization's name): # of Additional Participants (must list all participant's name/DOB; max 6 an application)Participant1
 
 Participant2
 
Participant3
 
 Participant4
 
Participant5
 
 Participant6
 
Location Of Solicitation (must contain specific details):
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Solicitation Date(s)Date/Hours of Solicitation (cannot exceed 36 hours in any 72 hour consecutive hour period)DAY 1DAY 2DAY 3Start Date/Time:
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End Date/Time:
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Start Date/Time:
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End Date/Time:
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Start Date/Time:
 
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End Date/Time:
 
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 Required UploadsPlease upload the following items:   Traffic Plan (reviewed by Traffic Engineering):
 
Click here to attach a file
Indigent Application or COI (insurance):
 
Click here to attach a file
Participant Indemnification, Hold Harmless Agreement- Exhibit C:
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to view a sample Traffic Plan to download the Indigent Application to download the Participant Indemnification and Hold Harmless agreement)  Hold Harmless and Insurance Requirements (Scroll down to view complete information)
     
 
 
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    Conditions
     
 
 
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to View a sample sign 
     
 
 
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   I agree to the terms and conditions outlined within the application:
    
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