Event Participation Request Form

Organization Info

Contact Person:

First Name

MI

Last Name

Email

Contact Phone Number:

Organization Name:

Organization Website:

Organization Tax ID #

Mailing Address

City

State

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Zip Code

Details of Request

Type of Request

Please select... Wayne Metro Participation in Event

What is the cost to participate?  If free, please put 0.

Event/Project Name:

Event/Project Date(s) 

Time Frame of Event/Project

Event/Project Address:

City:

Zip Code:

Overview

Projected attendance/participation: (if not applicable, use n/a)

Who will be served by this event and how does it help empower low-income individuals and/or strengthen Wayne County communities?: 

Due date of materials/funds:

Please specify request details:

Other community organizations participating at the event:

Name of Event Sponsor(s):

Please upload any supporting materials or flyers: