Permit Request Form- Memorial High School
Please complete and submit the following Form FIVE (5) or more business days in advance of your needed permit. If your request is urgent (sooner than five business days), please complete the form AND email Marlena Dow, medow@madison.k12.wi.us, directly to touch base.
For permit requests during the school day/contract hours (8:00am - 4:00pm), please contact Betty Loeffler. These requests will NOT be issued using this Form.
If you are NOT AFFILIATED with the Madison Metropolitan School District, Madison Memorial High School, or your request is not a district or school sanctioned event, you will need to contact Andy Deremo, at MMSD Space Rentals, ajderemo@madison.k12.wi.us, to request rental space. These requests will NOT be issued using this Form.
Start date requested *
MM
/
DD
/
YYYY
End date requested *
MM
/
DD
/
YYYY
Start time requested - please include set up time *
Time
:
End time requested - please include tear down time *
Time
:
Space (room number) requested *
Your answer
Special requests for permit- i.e. Technology needs, table set up, recurring permit days (every Thursday, etc.) *
Your answer
Event name, description *
Your answer
MMSD or JMM department or club affiliation *
Your answer
Name of person owning permit - responsible for damages, point of contact, etc. (They will be emailed the confirmation of permit) *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of MMSD. Report Abuse - Terms of Service