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Event & Activity Form - Roseville Campus
Must be completed 30 days before event/activity date. Please note: events cannot take place and communication cannot be sent out without first being approved by JAA Administration.
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* Indicates required question
Contact Person
*
Your answer
Type of Request
*
PSO
Enrichment Committee
Teacher
Admin
Scholar Government
John Adams Academy - Online
Other
Phone
*
Your answer
Email
*
Your answer
Title of Event/Activity
*
Your answer
Type of Event/Activity
*
Scholar-led Event/Activity
Parent-led Event/Activity
Academy Event/Activity
Community Event/Activity
John Adams Academy-Online Event/Activity
Fundraiser
PSO
Staff
Athletics
What is the reason or purpose of this event?
*
Your answer
Date of Event/Activity
*
MM
/
DD
/
YYYY
Start Time of Event/Activity
*
Time
:
AM
PM
End Time of Event/Activity
*
Time
:
AM
PM
Time of Set-up
*
Your answer
Time of Clean-up
*
Your answer
Location
*
Independence Hall (Elementary MPR - Only available on weekends or after 6pm M-F, including set-up time)
Adams Conference Room
Adams Staff Lounge
Liberty Hall (Washington MPR)
Washington Conference Room
Outside Commons
Jefferson Building
Other:
Estimated number of attendance
*
30 or less
31 - 75
76 - 120
121 - more
EQUIPMENT NEEDED
Please choose ONE of the 4 setup sections below (Dance, presenter, assembly, or concert) and check those items necessary for your event. If you have a picture/map of desired setup, please send it to
info@johnadamsacademy.org
. Thank you.
DANCE SETUP
Wireless Microphone
Corded Microphone
Projector
Laptop Connections
Dance Setup Comments (Please include number of chairs/tables, orientation and any other information that would assist the facilities team in setting up for the event)
Your answer
PRESENTER SETUP
Podium
Wireless Microphone
Corded Microphone
Microphone Stand
Projector
TV
Laptop
Laptop Connections
Presenter Setup Comments (Please include number of chairs/tables, orientation and any other information that would assist the facilities team in setting up for the event)
Your answer
ASSEMBLY SETUP
Podium
Wireless Microphone
Corded Microphone
Microphone Stand
Projector
TV
Laptop
Laptop Connections
Assembly Setup Comments (Please include number of chairs/tables, orientation and any other information that would assist the facilities team in setting up for the event)
Your answer
CONCERT SETUP
Podium
Wireless Microphone
Corded Microphone
Microphone Stand
Projector
TV
Risers
Laptop
Laptop Connections
Concert Setup Comments (Please include number of chairs/tables, orientation and any other information that would assist the facilities team in setting up for the event)
Your answer
OTHER SETUP
(Please be specific)
Your answer
I understand that the facilities team cannot guarantee any changes made less than 24 hours prior to the start of the event/activity.
*
Required
I understand by submitting this form it doesn't mean my event/activity has guaranteed approval.
*
.
Required
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