Open Flame/Pyrotechnics Permit Request

Applicant Name *

Applicant Phone Number *

Applicant Email *

Applicant Title

Show Title *

Show Dates *

Total number of shows *

Building *

Other address

If the building is not in the above list, give its address here.

Effects Information *

Please describe Effect Number, Type of Effect, Anticipated Duration, and Ingredients of the Open Flame / Pyrotechnics Effects.

University of Arizona Contact (Employee)

Contact Name *

Contact Email *

Contact Phone Number *

Contact Department *

Production Stage Manager *

Production Stage Manager and applicant have reviewed this information, which is an accurate description of the open flame/pyrotechnic effects intended for this production.

Technical Director *

Technical Director has reviewed this information and approved the use of these effects.

Costume Shop Manager *

Costume Shop Manager has reviewed this information and can provide appropriate flame-retardant treatment of the costumes.

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Open Flame/Pyrotechnics Permit Request