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F <br />CJ <br />City of South Bend Special Event Application <br />r <br />City and Regional Event <br />$50 application fee if filed 60 days or greater (up to 360 days) in advance of event <br />$100 expedited application fee if filed 30-59 days in advance of event <br />Please Brine Completed Application and Payment to: <br />Public Works Service Center, 731 S. Lafayette Blvd., South Bend, IN <br />Review the Instructions on the Special Events page before completing the application. City and Regional Special <br />Event applications must be submitted more than 30 days in advance of the event date or the application will not <br />be accepted. <br />Section A - Aoplicant Information <br />Date of Application: 12/19/2024 Organization Name: MLK Foundation/Project Impact <br />Applicant(Contact)Name: Gladys Muhammad <br />Applicant (Contact) Phone: 574-323-6292 Contact Email: aladyswmuhammac1Qgmail. com <br />Address: 802 Llncolnway West City/State/ZIP: South Bend, IN 46616 <br />List any professional event organizer, event service provider or commercial fundraiser that is authorized to work <br />on your behalf to plan, produce and/or manage your event. <br />Organization Name: N/A Contact Name: <br />Contact Phone: Contact Email: <br />Address: City/State/ZI P: <br />Section B - Event Information <br />Event Name: Martin Luther King Jr. Cele brat Type: (Festival, Race, Parade, Other): Celebration March <br />Event Classification: ® Non -Profit' ❑ For -Profit <br />[:]City (Civic) Sponsored ❑ Other (If Other, please describe): <br />`The Special Events Committee may request proof of non-profit status. <br />Provide a brief description and timeline of event (Note: A detailed map plan is required in Section H of this <br />application. The description should be a summary overview.) <br />Date of Event Setup[mm/dd/yy]: 1/20/2025 Time: <br />Begin Date of Event [mm/dd/yy]: <br />End Date of Event [mm/dd/yy]: <br />1 /20/2025 Time: <br />1 /20/2025 Time: <br />Event Cleanup Completion [mm/dd/yy]: <br />Total anticipated attendance: 300 <br />Time: <br />The proposed event will require the closing of: ❑ Streets 0 Sidewalks <br />This is a march on sidwalks, but no dosing required. <br />