Dance License Application

Valid for 1 year beginning July 1.

License Fee: Class A - $100, Class B - $25, Class C - No Fee

All fees are collected after the license has been approved by Village Board.

No license for a public dance shall be issued until the business complies with and conforms to all ordinances, health and fire regulations of the Village and of the State, is properly ventilated, supplied with sufficient toilet conveniences and is a safe and proper place for the purpose for which it is used.

Dance License Applied for: Please check all that apply.

Class A (Public Dance - Admission Fee, Advertised Event or Live Musicians)

Class B (Incidental Dancing - No Admission Fee, No Advertised Event and No Live Musicians)

Class C (Non-Profit, Fraternal, Church or School Organization)

Special Permit (Granted for One Public Dance)

Applicant Phone Number

Applicant Occupation/Birthdate

Occupation *

Birthdate *

Business Name

Has the applicant been licensed in the previous two years to conduct dance in Sussex? If "YES" please provide business name and address.

Has applicant been convicted of violating any law within the last two years? If YES", please explain.

Date

Sign Here

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.