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