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* 1. Your Name

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* 2. Name of your group/organization

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* 3. Please describe your event

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* 4. Date/Time of your event

Date / Time

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* 5. How many people do you expect to attend?

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* 6. I have a permit for this event

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* 7. My group plans to march/occupy a street for this event

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* 8. We expect counter protestors or alt-right protestors 

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* 9. We expect arrests

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* 10. Email and phone number for contact person 

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