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Raffle Bazaar Application
Town of West Stockbridge
Application for a Raffle or Bazaar

Name of Organization: _____________________________________________________

Street Address: ___________________________________________________________

Mailing Address:__________________________________________________________

Town: _______________________  State: ________________  Zip Code: ___________

Organization Type: _______________________________________________________

[You must fit the criteria for eligibility of a Raffle or Bazaar Permit]

Please list three [3] Officers of the organization who will be responsible for the operation of the Raffle or Bazaar.

Name                                    Title




Reason for Raffle or Bazaar: ____________________________________________


Date of Event: _________________________

Applicant's Signature: ______________________                  Date:  ____________

Print Name and Title: ______________________

Fee:  ________       

Approved/Disapproved                                    Approved/Disapproved

_______________________                                 _______________________ Town Clerk                                                               Chief of Police

Town of West Stockbridge 21 State Line Road, West Stockbridge, MA 01266
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