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2. Application for Skokie Boulevard/Niles Center Road Community Events Signage
   This application must be submitted at least thirty (30) days prior to the requested display. Dates and times of the display cannot be guaranteed.
3. 
5. Please review the policy guidelines (beginning on page 2)
   Policy Guidelines
7. Date Applied:
8. Organization Name:
10. Address:
12. Contact Person:
13. Telephone:
15. Event name:
17. Event Date (if applicable):
18. Display from:
    Display from: Start Date

    —

    Display from: End Date
20. I certify that I am an authorized representative of (please insert organization name) and have the power to execute this application on behalf of the above named organization:
22. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
24. Electronic Signature*
25. Date:
27. Title:
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

* indicates a required field