Event Application

2. Please fill out the following form and a representative from the La Porte Civic Auditorium will get back to you shortly.

   Please fill out the following form and a representative from the La Porte Civic Auditorium will get back to you shortly.

4. Applicant First Name*

5. Applicant Last Name*

7. Applicant Phone*

8. Person Signing Contract*

10. Mailing Address*

12. Address 2

14. City*

15. State*

16. Zip*

18. Name of Event

19. Number of Seats

21. Contact First Name*

22. Contact Last Name*

24. Phone*

25. Cell

27. Fax

28. Email*

30. Event Start
    Event Start

    Event Start

31. Event End
    Event End

    Event End

33. Move-In Day
    Move-In Day

34. Move-Out Day
    Move-Out Day

36. Rehearsal Date(s) & Time(s)

38. Space Requested

    1. Balcony Seating
    2. Entire Building
    3. Kitchen
    4. Lower Level Banquet Room
    5. Lower Level Room 1
    6. Lower Level Room 2

    1. Lower Level Room 3
    2. Main Floor / Gym
    3. Main Floor Coat Check
    4. Main Floor Concessions
    5. Stage
    6. Other

40. Clarify

42. Type of Event*

    1. Celebration / Reception
    2. Concert / Circus
    3. Conference
    4. Dance
    5. Exam / Test

    1. Exhibit / Trade Show
    2. Meeting
    3. Sporting Event
    4. Other

44. Clarify

46. Open to Public*

    1. Yes

    1. No

47. Charge for Admission*

    1. Yes

    1. No

49. Food to be Served*

    1. Yes

    1. No

50. Charge for Food*

    1. Yes

    1. No

52. Alcohol to be Served*

    1. Yes

    1. No

53. Charge for Alcohol*

    1. Yes
    2. No

55. Describe All Activities During Event

Leave This Blank:


56. 1. Receive email copy
57. Email address

    This field is not part of the form submission.

58. Submit

* indicates a required field