Facility Request Form

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It is understood that School District activities have preference over outside activities in using the school buildings and this request is subject to cancellation if the requested facility is needed for a school activity.

First Name *

Last Name *

Address *

Phone Number *

Email Address *

Organization / Group

Event Title *

As you want the Event to be shown on the Event Calendar

Facility Requested *

Ayersville Employee *

Events/Activities held on the Ayersville Local School District grounds are required to have an Ayersville Local School District employee responsible for the event. Please indicate below which employee has agreed to be the school representative.

Beginning Date *

YYYY

Time

Ending Date *

YYYY

Time

Purpose of Activity *

Technology Resources Needed *

None

Projection System

Microphone

Speakers System (for playing music)

DVD Player

Required

Admission Charge *

Yes

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