Becker District Facilities Request Form
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Name *
Name of Group *
Phone Number *
Email Address *
Name of Event  *
Date and approximate start of event *
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Time
:
Date and approximate end of event *
MM
/
DD
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YYYY
Time
:
What time do you need the doors opened *
Time
:
Name of the on site Supervisor for your event  *
Phone Number of the on site Supervisor for your event  *
Building(s) Requested (please check all that apply)
Space(s) are you Requesting (please check all that apply)
Field(s) Requested (please check all that apply)
Equipment Requested (please check all that apply) 
Are there any outside vendors that will be using the facilities?  *
Required
By typing my name in this box, I consent to have this serve as my digital signature for the following: I have read the 902 Policy Procedures: Use of School District Facilities and Equipment Manual and I agree to all items as outlined. I understand that in the event my organization or myself do not follow the procedures outlined we will be held liable for additional costs and could lost access to the space for future events.  *
This is only a request to use the school district facilities, not a confirmation of use.  This application will be considered and if approved, you will receive a Building Use Permit. Please call or email Community Ed with any questions. 
763-261-4506
jjohnson3@isd726.org
jedling@isd726.org
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