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THE COMMONWEALTH OF MASSACHUSETTS <br />• FEE <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 />jock C�tr(s Clkb o-� CAP�c o� <br />-0. max �AS t:�) .l E k Lk U65, UE <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 />K (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 raffle or bazaar: <br />Name Residence Address <br />(1) <br />(2) <br />(3) ) NV -'SH -1z6 ttt Com( fns -X"-L rtAIT'r ivr�> wryer t-v�.t-rt v1tlr <br />Uses to which net proceeds will be applied: ?2o C,C f dS Lo <br />c�o&AjIj-rk A,0,&i-Uv�y-,i� S49,� a�-rts� <br />Application certifie o be in <br />conformity with C. <br />0 <br />City/Town C1e <br />PERMIT (ISSUED) <br />The AI <br />bazaar <br />'fles and <br />1969: <br />OVER <br />FORM 810 Rm 12191 {{&W HOBSS& WARREN ru <br />