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City of Fairmont

info@fairmontwv.gov

200 Jackson Street, Fairmont, WV, 26554, US

304-366-6211

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Field Usage Request Form

Full Name

Personal Full Address

Is the Organization Insured

Start Date Requested

Date Picker

End Date Requested

Date Picker

Days of the Week Requested for Field Time

Have you contacted the City about your usage request prior to completing this request form?

Any questions, please contact Hanna Turner 304-36-6212 ext 340 or hturner@fairmontwv.gov