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TOWN OF BOSTON APPLICATION FOR USE OF TOWN MEETING FACILITY Boston Democratic Social Club Name/Organization ___________________________________________ 9 22 2026 Date_____/____/______ Barbara Moore Name of person responsible for facilities__________________________________________________ Chairperson Title _____________________________________________________________________________ Applicant Address _ _______________________________________ Applicant Daytime Phone #_______( 10 ______________# Of Attendees:______________ 10/6/2026 Date(s) Requested*_______________________Time 7pm ______________ Meeting Type of Event_____________ I, THE UNDERSIGNED, REQUEST PERMISSION TO USE THE FOLLOWING: (check all that apply) _____ Town Hall Community Room w/o Kitchen _____ Planning Board Room ______ Court Room I agree that all facilities used will be properly cleaned to the best of my ability upon completion of the event and that I will be responsible for any damages caused to any of the facilities or grounds . SIGNATURE OF APPLICANT: ________________________________________________________ Upon Completion, please submit to Town Clerk ************************************************************************************** 9/22/2026 APPROVED/DENIED : _____________________ (date) INSPECTION: _________________________ (date)