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Event Details
Official Name of Event:
 
Date and Time of Event Setup:
 
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Date and Time of Event Start:
 
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Date and Time of Event End:
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Date and Time of Breakdown Ending:
 
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Your Application Fee(Based on Dates Selected):
Please provide any further information on your Event Dates:
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Is this is a first time Event in Jacksonville?:
 
Expected Total Daily Attendance:
 
Maximum Hourly Attendance:
 
Event Location:
Venue Name:
 
Event Address or approximate Location(s) of Event:
 
Description of the Event:
 
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Ticket Pricing or Entry Fees:
Primary Contact First Name:
 
Primary Contact Last Name:
 
Primary Contact Office Phone:
 
Primary Contact Cell Phone:
 
Primary Contact Email:
 
Secondary Contact First Name:
 
Secondary Contact Last Name:
 
Secondary Contact Office Phone:
 
Secondary Contact Cell Phone:
 
Secondary Contact Email:
 
Entity conducting the event information
Name of Entity:
 
Address:
 
City:
 
State:
 
Zip:
State of Incorporation:
 
Entity EIN:
Is this Entity a registered 501c3?:
If yes, 501c3 certificate needs to be uploaded:
 
Click here to attach a file
Name of business, organization, or non-profit organization that is financially responsible for the event (if different from applicant):
 
Is this Entity exempt under 440 FL state statute from carrying workman’s compensation insurance?:
Assigned To:
 
 
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