Community Relations Request - Consolidated Utility District of Rutherford County

Event Name*

Event Organization*

Event Contact*

First Last

Event Phone Number*

Event Email Address*

Event Date*

Time Event Begins*

: HH

MM

Time Event Ends*

: HH

MM

Event Location*

Street Address Address Line 2 City State ZIP Code

Event Fee*

Describe Details of Event*

Provide Instructions for Check-In, Parking, etc for day of Event*

For School and/or Educational Events, provide grade levels in attendance and approximate number of students expected to participate*

Requesting Wally Water Mascot to attend?*

Candy permitted to give out?*