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2. First Name*
3. Last Name*
5. Email Address*
7. Phone Number*
9. Street Number*
10. Street Name*
11. Street Type
12. Apt #
14. City*
15. State*
16. Zip*
18. What is the name of your neighborhood?*
20. Provide the exact location of your event.*
22. Request for Street Closure

    1. Yes
    2. No
23. Request for barricades?

    1. Yes
    2. No

    Please note supplies are limited and all requests may not be fulfilled. 

25. Location for street closure, providing cross streets or house numbers:
27. Will you be serving any of the following?*

    1. Food
    2. Beverage
28. What is your estimated attendance?*
30. Will you have a food vendor at your event?*

    1. Yes
    2. No
31. Name of food vendor?
33. Would you like a visit from any City Services or Elected Officials?

    1. Police Department
    2. Fire Department
    3. Code Compliance
    4. Public Works
    5. Neighborhood Engagement
    6. Recreation
    7. Planning and Development
    8. City Council
    9. Other
35. What (if any) other amenities will be provided at this event?*
37. Would you like to enter a drawing to use the Neighborhood Engagement Block Party Trailer?*

    1. Yes
    2. No
39. Please provide any additional details you would like us to know about your event?
41. Would you be interested in being a Block Captain for Neighborhood Watch?*

    1. Yes
    2. No
43. Noise Ordinance*

    1. Agree

    If you are going to have outdoor entertainment, you must comply with City and State Noise Ordinances. The City Noise Ordinance #87-2003 states that outdoor music shall not be heard 50 feet or more away from the party location. This Ordinance also states that there should not be any vulgar or foul language that might offend anyone in your neighborhood.

45. National Night Out 2023

    Please understand that the street must remain clear from the passage of emergency vehicles. All items including bounce houses, a stage or games must be off the concrete and away from fire hydrants.

    
    

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47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit

* indicates a required field