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<title>Block Party Email</title>
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<body background="../_themes/copy-of-blends/blegtext.gif" bgcolor="#CCCCCC" text="#000000" link="#0000FF" vlink="#CC3300" alink="#0000FF"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica"><!--mstheme--></font><table border="0" cellpadding="0" cellspacing="1" style="border-collapse: collapse" width="100%" id="AutoNumber1" height="247">
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<img border="0" src="../images/townseal.gif" width="150" height="183"></p>
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<a href="../xTownMisc/oldindex.htm">Needham Home Page</a></font><!--mstheme--></font></td>
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<img border="0" src="selectmen.gif" align="right" width="607" height="87"><p style="margin-top: 1; margin-bottom: 1"> </p>
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<p style="margin-top: 1; margin-bottom: 1"><b>
<font face="Verdana" size="2">1471 Highland Avenue</font></b></p>
<p style="margin-top: 1; margin-bottom: 1"><b>
<font face="Verdana" size="2"> Needham, MA 02492<br>
Phone - 781-455-7500<br>
Fax - 781-449-4569</font></b><p style="margin-top: 1; margin-bottom: 1">
<b><font face="Verdana" size="2">Email: </font></b>
<a href="mailto:[email protected]">
<font face="Verdana, arial, helvetica" size="2" color="#0000FF">GenInfo</font></a><font face="Verdana, arial, helvetica" color="#FFFFFF" size="2"><a href="mailto:[email protected]"><font color="#0000FF">@town.needham.ma.us</font></a></font><!--mstheme--></font></td>
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<p></p>
<p align="center" style="margin-top: 1; margin-bottom: 1">
<font color="#0000FF" face="Verdana" size="5"><b>Town of Needham</b></font></p>
<p align="center" style="margin-top: 1; margin-bottom: 1"><b>
<font color="#0000FF" face="Verdana" size="5">Block Party Permission Form</font></b></p>
<p align="center" style="margin-top: 1; margin-bottom: 1"> </p>
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</table><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica"><!--mstheme--></font><table border="0" cellpadding="0" cellspacing="1" style="border-collapse: collapse" width="100%" id="AutoNumber2">
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<a href="SelectmenBlockPartyApplication.htm">Block Party Application</a><!--mstheme--></font></td>
<td width="50%" style="border-left-width: 1; border-right-width: 1; border-top-width: 1; border-bottom-style: solid; border-bottom-width: 1" bordercolor="#C0C0C0" align="center" height="68"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<a href="Index.htm">Board of Selectmen Home</a><!--mstheme--></font></td>
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<td width="101%" colspan="2"><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<o:p>
<p style="margin:1 5; text-indent: 0; " align="center">
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</table><!--mstheme--><font face="Trebuchet MS, Arial, Helvetica">
<form method="POST" action="../_vti_bin/shtml.dll/xSelectmen/SelectmenBlockPartyEmail.htm" onSubmit="" webbot-action="--WEBBOT-SELF--">
<!--webbot bot="SaveResults" s-email-format="HTML/BR" b-email-label-fields="TRUE" b-email-replyto-from-field="FALSE" s-email-replyto="Repy-to Line:" b-email-subject-from-field="FALSE" s-email-subject="Block Party Permission Form 2006" s-builtin-fields S-Email-Address="[email protected]" startspan --><input TYPE="hidden" NAME="VTI-GROUP" VALUE="0"><!--webbot bot="SaveResults" endspan i-checksum="43374" --><p style="margin: 1 5">
<b><font face="Verdana" size="2">Applicant Name:</font></b></p>
<p style="margin: 1 5"><font face="Verdana"><b>
<input type="text" name="ApplicantName" size="60"></b></font></p>
<p style="margin: 1 5"><b><font face="Verdana" size="2">Applicant Address:</font></b></p>
<p style="margin: 1 5"><font face="Verdana"><b>
<input type="text" name="ApplicantAddress" size="60"></b></font></p>
<p style="margin: 1 5"><b><font face="Verdana" size="2">ZIP:</font></b></p>
<p style="margin: 1 5"><font face="Verdana"><b><select size="1" name="ZIP">
<option selected>02492</option>
<option>02494</option>
</select></b></font></p>
<p style="margin: 1 5"><b><font face="Verdana" size="2">Daytime Telephone
Number:</font></b><font face="Verdana"><b> </b></font></p>
<p style="margin: 1 5"><font face="Verdana"><b>
<input type="text" name="DaytimeTelephoneNumber" size="60"></b></font></p>
<p style="margin: 1 5"><b><font face="Verdana" size="2">Applicant Email:</font></b></p>
<p style="margin: 1 5"><input type="text" name="ApplicantEmail" size="60"></p>
<p style="margin: 1 5"><b><font face="Verdana" size="2">Location of Event:</font></b></p>
<p style="margin: 1 5"><font face="Verdana"><b>
<input type="text" name="LocationOfEvent" size="60"></b></font></p>
<p style="margin: 1 5"><b><font face="Verdana" size="2">Date of Event:</font></b></p>
<p style="margin: 1 5"><font face="Verdana"><b>
<input type="text" name="DateOfEvent" size="60"></b></font></p>
<p style="margin: 1 5"><b><font face="Verdana" size="2">Rain Date:</font></b></p>
<p style="margin: 1 5"><font face="Verdana"><b>
<input type="text" name="RainDate" size="60"></b></font></p>
<p style="margin: 1 5"><b><font face="Verdana" size="2">Hours of the Event:</font></b></p>
<p style="margin: 1 5"><font face="Verdana"><b>
<input type="text" name="HoursOfTheEvent" size="60"></b></font></p>
<p style="margin: 1 5"><b><font face="Verdana" size="2">Do you want to use
D.P.W. Road Barriers?</font></b></p>
<p style="margin: 1 5"><font face="Verdana"><b>
<input type="radio" value="Yes" name="RoadBarriers"><font size="2"> YES
</font><input type="radio" name="RoadBarriers" value="No" checked><font size="2">
NO</font></b></font></p>
<p style="margin: 1 5"><b><font face="Verdana" size="2">If you answer YES,
when you receive permission for the above Block Party you should contact the
Public Works Department at (781) 455-7534 to arrange for availability and pick
up.</font></b></p>
<!--msthemeseparator--><p align="center"><img src="../_themes/copy-of-blends/blesepa.gif" width="600" height="10"></p>
<p style="margin: 1 5"> </p>
<p style="margin: 1 5" align="center"><b><font face="Verdana" color="#FF0000">
Block Party Permission Forms should be submitted</font></b></p>
<p style="margin: 1 5" align="center"><b><font face="Verdana" color="#FF0000">
at least one month before the scheduled event.</font></b></p>
<p style="margin: 1 5"> </p>
<p align="center">
<input type="submit" value="Submit Form" name="SubmitButton"><input type="reset" value="Reset Form" name="ResetButton"></p>
</form>
<form method="POST" action="../_vti_bin/shtml.dll/xSelectmen/SelectmenBlockPartyEmail.htm" onSubmit="" webbot-action="--WEBBOT-SELF--">
<!--webbot bot="SaveResults" u-file="../_private/feedback.txt" s-format="TEXT/TSV" s-label-fields="TRUE" s-builtin-fields="Date Time REMOTE_NAME REMOTE_USER HTTP_USER_AGENT" s-form-fields startspan --><input TYPE="hidden" NAME="VTI-GROUP" VALUE="1"><!--webbot bot="SaveResults" endspan i-checksum="43406" -->
</form>
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