2. 
3. Middleton Field Use Request Form
5. Your Organization
7. Name
8. Email Address
10. Address
12. City
13. State
14. Zip Code
16. Phone Number
17. Fax Number
19. Alternate Contact Person
20. Phone Number
22. Event or Activity
24. Number of Youth Participants
25. Number of Adult Participants
27. Field Preference - First Choice
    -- Select One --Memorial Hall/Tragert Common FieldEmily Maher (Natsue Way) FieldRubchinuk ParkHowe Manning FieldFuller Meadow FieldNo preference
28. Field Preference - Second Choice
    -- Select One --Memorial Hall/Tragert Common FieldEmily Maher (Natsue Way) FieldRubchinuk ParkHowe Manning FieldFuller Meadow FieldsNo preference
30. Date or Dates Requested
32. Beginning and Ending Time(s)
34. Please indicate the type of organization:

    1. Middleton Public Schools
    2. Middleton Youth Sports Groups (Non-Profit benefitting Middleton youth)
    3. Middleton Recreation Department Programs
    4. Middleton Non-Profit Community Group (60% or more Middleton residents or adults that work in Middleton)
    5. Middleton Non-Profit Community Groups (between 25% and 59% Middleton residents or adults that work in Middleton)
    6. Middleton For-Profit Entities (with 25% or more Middleton residents or adults that work in Middleton)
    7. Other (please describe in the Additional Comments section)
36. Are you charging a fee for this event?

    1. Yes
    2. No
37. If you are charging a fee, how much?
39. Additional Comments
41. Please note that until the permit has been processed, the field is not reserved. We recommend not advertising your event until the permit has been completely processed.
    You will receive an email after your permit request has been processed.
43. By signing this form, I acknowledge that I have read and agree to comply with the Field Use Policy.
45. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
47. Electronic Signature
49. Questions may be directed to the DPW at 978-777-0407 or email paul.goodwin@middletonma.gov
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51. Submit Submit and Print

* indicates a required field