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THE COMMONWEALTH OF MASSACHUSETTS <br /> FEE 00 <br /> (city or town) <br /> APPLICATION FOR PERMIT TO CONDUCT RAFFLES AND BAZAARS <br /> (C. 810, ACTS OF 1969) <br /> Name and address of Nonprofit Organization: <br /> -------------------- <br /> a <br /> Evidence of Qualification for Permit: <br /> ❑ (a) Veterans'organization chartered by the Congress of the United States or included in clause (12) <br /> of section five of chapter forty of the General Laws; or, <br /> ❑ (b) Church or religious organization; or, <br /> ❑ (c) Fraternal or fraternal benefit society; or, <br /> (d) Educational or charitable organization; or, <br /> ❑ (e) Civic or service club or organization; or, <br /> ❑ (f) Club or organization organized and operated exclusively for pleasure, recreation and other <br /> nonprofit purposes, no part of the net earnings of which inures to the benefit of any member or <br /> shareholder. <br /> Officers or members of organization responsible for operation of raffie or bazaar: j <br /> Name Residence Address <br /> (1) -----------1rJ- _ <br /> Uses to which net proceeds will be ap lied: .................. <br /> . ------r------------•--- ------- ---/Z.,-- ------------------ <br /> - <br /> -� - � <br /> -------------------------------------------------------------------------------------•---------------------------------------------------------- <br /> s : _ <br /> Application certified to be in (signature of authorized officer or member of organization) <br /> conformity with C. 810, Acts <br /> of <br /> q-a�city/Town <br /> Clerk <br /> PERMIT (ISSUED) (L ) <br /> i <br /> (da 1------- The applicant (is) 4&4iet) qualified to operate raffles and <br /> bazaars under the provisions of C. 810, Acts of 1969: <br /> --•------ <br /> City/Town rk <br /> Chief o P ce <br /> CURTIS . FRYE <br /> CHIEF OF POLICE <br /> MASHPEE <br /> FORM 810 Hoil & WARREN, INC. <br />