DC Permit
DC Permit
Date of Event:
Location: Principal Ofcer/Person in Charge (If there is a different person in charge of activities at different locations, each person must be listed):
Contact Information (include area codes with phone numbers) Day Phone Number: Evening Phone Number: Cell Phone Number: Fax Number: Email Address(es): Event Information Name of Group: Estimated Number of Participants: Assembly Time: Disbanding Time:
List any special equipment (props, stages, sound equipment, other structures) that will be used in assembly or rally areas (If additional space is needed, please list on a separate sheet):
Any planned civil disobedience: Yes No (If yes, please indicate the individual/group, number of participants & locations)
Signature
MPDC Assembly/Picket Plan Notication
Date
Rev August 2006