City of Belvidere
401 Whitney Blvd., Belvidere, IL 61008 (815)544-2612
CHARITABLE SOLICITATION AND COMMERCIAL CANVASS MERCHANDISING REGISTRATION FORM
Name of Organization
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Address of Organization
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number of Organization
*
Please enter a valid phone number.
List of Officers
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Name of Solicitation Chairman
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First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Nature of Solicitation
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Funds Used For
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Names of three most recent municipalities where applicant has solicited door to door
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Full Names of Solicitors
*
Please Upload Driver's License of Solicitors
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In consideration of the grant of permit, the above named applicant agrees that the act of soliciting within public streets and alleys is a dangerous activity. The above named organization agrees to hold harmless, defend and indemnify the City of Belvidere from any and all claims, actions, suits and damages arising out of, or in any way related to, the organization's solicitation activities.
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