This form requires the approval of the Coronet, the Seneschal and the Financial Committee prior to the disbursal of funds.
Please fill out the Site Information completely.
Attach additional sheets if necessary.
Name of Event: _____________________________________________
Date of Event: ______________________________________________
Site Name and Address: ______________________________________
__________________________________________________________
Site Contact (Mundane person to contact about site issues)
__________________________________ Phone: _________________
Autocrat(s):
Responsible for-- Society Name---- Mundane Name---- Phone #
____________ ________________ ________________ ________