Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1698754413466.pdf (Saint Kitts and Nevis)
ST CHRISTOPHER & NEVIS Tel: (869) 467 – 1314 Fax: (869) 465-9273 Email: skbcommunitydevelopment@gmail.com DEPARTMENT OF SOCIAL SERVICES AND COMMUNITY DEVELOPMENT Victoria Road, Basseterre, St Kitts, W.I COMMUNITY MULTI-PURPOSE CENTRE REQUEST FORM Community Center: _________________________________________________________________ SECTION A Title/Type: EVENT LOGISTICS __________________________________________________________________ Date: __________________________________________________________________ Start Time: ____________________ End Time: __________________________ Hours of Reservation: ____________________ to ________________ (must include set up and cleanup) Room(s) requested: __________________________________________________________________ Expected Attendance: ____________________ Age Range of Attendees: _____________________ SECTION B: Contact Person: APPLICANT CONTACT INFORMATION __________________________________________________________________ Organization: _________________________________________________________________ Mailing Address: _________________________________________________________________ Phone: Email: __________________ (Cell) ______________ (Home) ________________ (Fax) _________________________________________________________________ EVENT DETAILS SECTION C: Food Service and Alcohol Will food be served?
If yes, will the kitchen be used?

Will alcohol be served?

Will music be played?

Will any income be generated from this event?
If yes, please indicate how this revenue shall be utilized __________________________________________________________________________________________ _____ Yes _____ No _____ Yes _____ No _____ Yes _____ No _____ Yes _____ No _____ Yes _____ No _________________________________________________________________________________________ __________________________________________________________________________________________ Applicant Signature: _________________________________________________________________ Date: _________________________________________________________________ _______________________________________________________________________ “Achieving Social Justice, Development, and Gender Equity through Community Development” For Office Use Only SECTION A VERIFICATION INFORMATION Date Application Received: ____________________________________________________________ Signature of Receiving Officer: ___________________________________________________________ SECTION B Decision: DECISION _____ Approved _____ Denied Conditions of Approval: ____________________________________________________________ Reason for Denial: ____________________________________________________________ ___ ________________________________________________________ ____________________________________________________________ SECTION C: Deposit requested: Method of Payment: Receipt Number: Payment Date: PAYMENT INFORMATION _____ Yes _____ Cash _____ No _____ Check ____________________________________________________________ ____________________________________________________________ Receiving Officer: _____ Mrs. Adams-Browne ___ Mrs. Wigley ___ Mrs. Ward-Harris SECTION D: COMMUNICATION WITH APPLICANT Dispatch of Notification Letter: ________________________________________________________ NOTATIONS SECTION E: ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________