Facilities Use Form
Notice: This form must be filled out by the event coordinator (adult in charge) and submitted at least 2 weeks prior to your event. Late requests will not be guaranteed building access, event setup, or custodial, kitchen or event setup staffing. Please fill out separate requests for non-recurring events.
Email address *
Event coordinator name: *
Your answer
Event coordinator phone: *
Your answer
Group name: *
Your answer
Proof of liability insurance on file: *
Building: *
Required
Event type: *
Event purpose: *
Your answer
Event start date: *
MM
/
DD
/
YYYY
Event start time: *
Time
:
Event end date: *
MM
/
DD
/
YYYY
Event end time: *
Time
:
Is this a recurring event? (e.g. first Tuesday of every month) *
If this is a recurring event, what is the schedule?
Your answer
Rooms/areas needed (list all): *
Your answer
Approximate number of attendees: *
Your answer
Is there an admission fee? *
Setup/tear-down required? *
If setup/tear-down is required, please explain:
Your answer
Building access: *
Notice: Keys for individual areas, rooms, or equipment must be obtained from the administrative office and signed out by the event coordinator.
What department assistance will you need: *
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