APPLICATION/PERMIT FOR USE OF SPACE
ON THE PENTAGON RESERVATION
INSTRUCTIONS
Type or print in ink. Attach this request to a cover letter which includes information required by Part II of the "Exhibits,
Displays, Performances, Special Events, and Ceremonies Policies, Procedures, and Guidelines." Include copies, samples,
drawings, and descriptions of the materials to be displayed or distributed. Failure to complete this form will delay the
issuance of a permit and could result in a denial of the permit requested. See Conditions on back.
SECTION I (To be completed by applicant)
1. APPLICANT
a. NAME
b. ORGANIZATION
c. ADDRESS (Include Room Number)
d. TELEPHONE NUMBER (Include Area Code)
e. FAX NUMBER (Include Area Code)
f. E-MAIL ADDRESS
IF APPLICANT WILL ACT ON HIS/HER OWN BEHALF, GO TO ITEM 3.
2. ORGANIZATION SPONSORING, PROMOTING, OR CONDUCTING THE PROPOSED ACTIVITY
a. ORGANIZATION NAME
b. NAME OF AUTHORIZED REPRESENTATIVE
c. TITLE
d. ADDRESS (Include Room Number)
e. TELEPHONE NUMBER (Include
f. FAX NUMBER (Include Area
g. E-MAIL ADDRESS
Area Code)
Code)
3. DETAILED DESCRIPTION OF PROPOSED ACTIVITY, INCLUDING EXACT LOCATION (Cover letter may be used)
TEMPORARY EXHIBIT
PERMANENT EXHIBIT
CEREMONY
PERFORMANCE
SPECIAL EVENT
DESCRIPTION:
4. APPROXIMATE NUMBER OF PERSONS
5. PROPOSED DATES AND HOURS OF THE ACTIVITY
TO BE ENGAGED IN THE ACTIVITY
INDEFINITE (Permanent Exhibit)
TEMPORARY (Complete below)
(1) MONTH
(2) DAY
(3) YEAR
(4) HOUR
a. FROM
b. TO
6a. SIGNATURE OF APPLICANT
b. DATE SIGNED
IMPORTANT: If the applicant represents an organization, a letter or other documentation that the applicant has authority to
represent the organization is required to be submitted with this form.
7a. SIGNATURE OF ORGANIZATION'S AUTHORIZED REPRESENTATIVE (If applicable)
b. DATE SIGNED
SECTION II (To be completed by the Building Management Office)
8. DESIGNATED LOCATION AND ACTUAL DATES AND HOURS FOR WHICH THE ACTIVITY IS APPROVED
a. LOCATION
APPROVED
DISAPPROVED
b. PERMIT NUMBER
c. DATE(S)
d. HOURS
9a. SIGNATURE OF APPROVING OFFICIAL
b. DATE SIGNED
DD FORM 2798, DEC 1999
PREVIOUS EDITION IS OBSOLETE.
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