Pocono Irish American Club

Established 1978

         Application Form for the 39th annual st. patrick's day parade              sunday, march 20th, 2016 .....no longer accepting applications!

(Please print)

Name of Organization_______________________________________________________________

Contact Person____________________________________________________________________

Mailing Address___________________________________________________________________

City__________________________________________ State ____________Zip________________

Contact Phone Number: ____________________________________________________________

E-Mail__________________________________________________________________________

 Type of Unit

Marching Unit_____  Float _____ Music or Amplifying Sound______Other _____________________

If using music/amplifying sound please describe________________________________________

______________________________________________________________________________

Number of marchers in your unit____________

Please describe the nature of your parade unit:_________________________________________

_____________________________________________________________________________

Is your group insured?  Yes ____  No ____

Insurance Carrier Name:__________________________________Policy Number:_____________

Name:____________________________________Title/Rank_____________________________

Signature:______________________________________________________Date:____________

Please mail this form along with the signed Rules and Regulations Form, signed Liability Waiver Form and relevant fee to the following address. PIAC, Parade Committee, P.O.Box 852, East Stroudsburg, PA 18301                                                                                                                                               

 PARADE APPLICANTS WILL BE REVIEWED AND NOTIFICATION WILL BE SENT VIA E-MAIL

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