1983-VARIETY OF YEARS-RAFFLES AND BAZAARS - BOOK-TAN ALPHABETICAL WOMENS ETC

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c2 Y77 17 THE COMMONWEALTH OF MASSACHUSETTS FEE $10.00 _ r_ r (city fr town) APPLICATION FOR PERMIT TO CONDUCT RAFFLES AND BAZAARS (C. 810, ACTS OF 1969) Name and address of Nonprofit � Org ization: Ett' � �' C t -FCC(------ � � � cAre r`1A rt � Evidence of Qualification for Permit: ❑ (a) Veterans'organization chartered by the Congress of the United States or included in clause (12) of section five of chapter forty of the General Laws; or, ❑ (b) Church or religious organization; or, ❑ (c) Fraternal or fraternal benefit society; or, g'(d) Educational or charitable organization; or, ❑ (e) Civic or service club or organization; or, ❑ (f) Club or organization organized and operated exclusively for pleasure, recreation and other nonprofit purposes, no part of the net earnings of which inures to the benefit of any member or j shareholder. Officers or members of organization responsible for operation of raffle or bazaar: Name Residence Address (1) % l-Q2v - EfA��r--1 �t�( �J---- ---�--`-.L ( A��E /��e: v� > ---.-.. . (2) ------------------------------------------------------------------------------ (3) -------------------------------------------------------- --------------- - -------- ------------------------------- ------------------------------------------ - Uses to which net proceeds will be applied: __-__----�_ �'` Cit, -,'-.---.--"`"--`--A e /� �^ ----------------- ----------- ------ .`'i f-t A-- ` -C--------......(-f --------------- - ------------ -------------------- ------------------------- = (signature of authorized office- or member o organization) Application certified to be in conformity with C. 810, Acts of 1969 f _= 1 City/Town Clerk PERMIT (ISSUED) (D9NJ-E-P) The applicant (is) (4-n-at) qualified to operate raffles and (date) bazaars under the provisions of C. 810, Acts of 1969: City/Town Clerk ll ------...... GSA- ---- ------------------ Chi ke FORM 810 HOBBS & WARREN, INC.