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TOWN OF BOSTON APPLICATION FOR USE OF TOWN MEETING FACILITY Connect Life ToB Blood Drive Name/Organization ___________________________________________ 7 13 2026 Date_____/____/______ Barbara C Moore Name of person responsible for facilities__________________________________________________ Title _____________________________________________________________________________ Applicant Address _ ____________________________________ Applicant Daytime Phone #_ 40? __________________# Of Attendees:______________ *Please see attached Date(s) Requested*_______________________Time 2-7 pm ______________ Blood Drive Type of Event_____________ I, THE UNDERSIGNED, REQUEST PERMISSION TO USE THE FOLLOWING: (check all that apply) X _____ 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 ************************************************************************************** 7/14/26 APPROVED/DENIED : _____________________ (date) INSPECTION: _________________________ (date)