Request edit access
School Facilities Request Form
This form must be completed prior to the consideration of any rental request. The district's rental policy and fee schedule can found here:
Email *
Name of Organization *
Location of Organization
Certificates of Insurance will be required of all renters
 *
Can you provide a general liability/property insurance certificate of $1,000,000 each occurrence/ $2,000,000 aggregate to the School District?
 *
Name of Individual Making Request
 *
Phone Number
 *
Email Address *
Date Requested for Rental
 *
MM
/
DD
/
YYYY
Starting Time of Activity
If multiple dates, please list detail in Type of Activity.
 *
MM
/
DD
/
YYYY
Time
:
Ending Time for Activity
 *
MM
/
DD
/
YYYY
Time
:
Please describe the time break down of your activity
Will an admission fee be charged?
 *
Specific Space Requested
 *
Required
Describe any special set-up requested
 *
Group Level *
  Building Rental Fees 

Group I: These groups will not be charged for the use of facilities and/or equipment. This includes groups and/or athletic teams that have more than ½ of the participants who are students of the Pawnee Schools. 
Group II: These groups will not be charged provided school personnel take full responsibility for the actions of the group. 
Group III: The charge for the facility use will be the following hourly rate:                          
Captionless Image
Status of Request
If approved skip the next item.
Reason for Denial
If approved, additional requirements for the rental.

A copy of your responses will be emailed to .
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Pawnee CUSD 11.

Does this form look suspicious? Report

Google Forms