Welcome to City of High Point Form Center

2. Applicant and Organization Information
4. Business Name: *
6. ABC Permittee:*
7. Title: *
9. Physical Address*
11. City*
12. State*
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13. Zip Code*
15. MailingAddress*
17. City*
18. State*
    -- Select One --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
19. Zip Code*
21. Mobile Phone: *
22. Email Address*
24. Alternate Contact
26. Name
27. Title
29. Address
31. City
32. State
    -- Select One --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
33. Zip Code
35. Phone Number
36. Email

38. I.    Registrant must ensure all activities comply with state and federal laws and City of High Point Ordinances.

    II.    Information on this application has been adapted from the approved High Point Social District Ordinance.  A full copy of this plan may be obtained on the City website.

    III.    This permit may be revoked by any supervisory High Point Police Department Officer upon non‐compliance of the permit.

42. Read and Understand*

    1. I have read and understand this registration and the requirements placed upon this applicant and organization.
    2. This registration and my signature acknowledgement below indicate that I am aware and reviewed the documentation identifying the High Point Social District
    3. I agree to abide by the City of High Point rules, regulations and ordinances should my permit application be approved, and I will fulfill the requirements placed upon this permit application.
44. 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.
46. Electronic Signature*
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit Submit and Print

* indicates a required field