L&G Building Use and Special Activities Request Form
This form must be returned two weeks in advance for all events. Any questions please contact Marty Testo at 365-7355 ext 151
Email address *
Title of event: *
Your answer
Date(s) of event: *
MM
/
DD
/
YYYY
Start time of event: *
Time
:
End time of event: *
Time
:
Name of person in charge of the activity: *
Your answer
Facility(s) Requested: *
Your answer
Do you need assistance from the maintenance department? If so, please explain. *
Your answer
Number of extra chairs required: *
Your answer
Number of extra tables required: *
Your answer
Number of people attending: *
Your answer
Special equipment/technology? Please describe: *
Your answer
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