Facilities Request
Email address
Name
Your answer
Name of student organization requesting facility
Your answer
Type of Activity / Event
Your answer
If this is a fundraiser, has it been approved by Mr. Brubaker?
Start Date
MM
/
DD
/
YYYY
End Date
MM
/
DD
/
YYYY
Reservation Start Time
Time
:
Reservation End Time
Time
:
Facility Requested
Required
Equipment / Special Needs: Please include necessary details including number for specific items (tables, chairs, opening of bleachers, microphone, etc.)
Your answer
I agree that any Arlington facility my organization has used will be left in the same condition it was found. Furniture provided will not be damaged. Trash/debris will be picked up and placed in trashcans, paperwork or equipment will not be tampered with (Please sign by typing full name before submitting form).
Your answer
A copy of your responses will be emailed to the address you provided.
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