ROOM/ SPACE/ BUILDING USE FORM

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TO REQUEST A SPACE IN THE SCHOOL BUILDING, PLEASE FILL OUT THE REQUIRED FIELDS BELOW AND SUMBIT TO MS. MOORE FOR APPROVAL. PLEASE SUBMIT THE FORM ONE WEEK IN ADVANCE TO RESERVE THE REQUESTED SPACE. IF THIS FORM IS SUBMITTED LESS THAN A WEEK BEFORE YOUR EVENT, IT WILL NOT BE APPROVED

Email *

Applicant's Name *

Room Requested

Today's Date: *

YYYY

Event Date: *

YYYY

Event Set Up Time *

Time

Event Time *

Time

Event Cleanup Time *

Time

Applicant's Phone Number *

Expected Number of Attendees *

Program/ Meeting Title *

Program Start Date

YYYY

Program End Date

YYYY

Check all that apply *

Check here if you are reserving the room for a program

Check here if you will have food items during the event.

Check here if you will have beverages during the event

Required

ROOM REQUESTED *

Gym

Cafeteria

Classroom

Auditorium

Library

Other

Required

P.S. 41 Staff ONLY: Items you will be using: Check all that apply.

Projector

Microphone

Promethean/ SMART board

Cups

Plates

Utensils

Napkins

Other

ADMIN USE ONLY: Approval Status

Approved

Denied

ADMIN USE ONLY: Reason For Denial

Submit

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