Form Center

2. This application is pending availability, approval, and a completed lease agreement.

   Upon receipt of this application, a staff member of the Senior Center will contact you to schedule an 
    on-site appointment to view the space and finalize the lease agreement if the space is available. Our staff hours are Monday – Friday 8:30 a.m. – 4:30 p.m.

4. Name of Person/Organization*
6. Event Name*
8. First Name*
9. Last Name*
11. Daytime Phone Number*
13. Evening Phone Number*
15. Address*
17. City*
18. State*
19. Zip Code*
21. Email Address*
25. Date and Time of Event*
    Date and Time of Event Start Date

    Date and Time of Event Start Time

    —

    Date and Time of Event End Date

    Date and Time of Event End Time

    Please put in a beginning and ending time for your event, including set-up time.

27. Do You Need an Additional Date (for event or set-up)*

    1. Yes
    2. No
29. Additional Date and Time Needed*
    Additional Date and Time Needed Start Date

    Additional Date and Time Needed Start Time

    —

    Additional Date and Time Needed End Date

    Additional Date and Time Needed End Time
33. Senior Center Member*

    1. Yes
    2. No
35. Non-Profit Organization*

    1. Yes
    2. No

    501(c)3 document required for non-profit pricing and tax-exempt status.

37. City of Niceville Resident*

    1. Yes
    2. No

    FOR US TO VERIFY YOUR IDENTITY & RESIDENCY, YOU MUST PROVIDE THE FOLLOWING WHEN YOU COME TO FINALIZE THE LEASE AGREEMENT:

    • One photo identification
    • One residency document

    A current state-issued ID or driver’s license will fulfill both identity and residency requirements.

    PHOTO IDENTIFICATION
    

    Your photo identification must show your name, date of birth, and photograph. 
     You can use any document from the following list:

    • State identification (ID) card
    • Driver’s license
    • US passport or passport card
    • US military card (front and back)
    • Military dependent’s ID card (front and back)
    • Permanent Resident Card
    • Certificate of Citizenship
    • Certificate of Naturalization
    • Employment Authorization Document
    • Foreign passport

    ADDRESS VERIFICATION:

    • State identification (ID) card
    • Driver’s license
    • Any bill or financial statement showing your name and residence address
    • Utility bill (electricity, gas, garbage, water, or sewer)
    • Cable TV or internet bill
    • Telephone bill
    • Bank statement
    • Property tax bill
    • Mortgage statement
    • Lease or rental agreement showing your name and residence address
    • If you own property in the City limits but live outside the City limits, you can provide any of the above for your property in the City limits.

39. This application is pending availability, approval, and completed lease agreement.

    Upon receipt of this application, a staff member of the Senior Center will contact you to schedule an 
     on-site appointment to view the space and finalize the lease agreement if the space is available. Our staff hours are Monday – Friday 8:30 a.m. – 4:30 p.m.

Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit Submit and Print

* indicates a required field