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2. Community Service Banner Request
4. Organization / Business:*
6. Non Profit / For Profit:*

   Check one:

   1. Non Profit

   1. For Profit
7. Tax ID #:*
9. Contact Name(s):*
11. Mailing Address:*
13. City*
14. State*
15. Zip Code*
17. Phone Number(s):*
18. Email Address:
20. Site Descriptions:
22. Site 1: 600 East Main
23. Site 2: 200 West Main
24. Site 3: 300 West Main
26. Site 4: Hwy 16 South, near High School
27. Site 5: Hwy 16 South & Pyka Rd
29. You may request any number of dates. These requests will be filled on a first come, first served basis. All requests should be submitted by the end of November of the year prior to the date of the banner request.
31. Please check one of the following:*

    1. I am willing to accept other Main Street sites, if my first choice is not available.
    2. I am willing to accept any other site, if my first choice is not available.
33. Event date(s)*

    Please enter the date(s) of your actual event

35. Please list your event name, any other important details, and indicate the dates and site you want:*
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field