Application for Use of District Facilities
Pacific Elementary School District
Email address *
Tell us about your Organization
Date of Application
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Name of Your Organization
Your answer
Name of Primary Contact Person
Your answer
Phone
Your answer
Fax
Your answer
Complete mailing address
Your answer
Tax ID #, if applicable
Your answer
Tell us about your plans.
Briefly describe your event.
Your answer
Facility(ies) requested
Some use of facilities requires custodial support, any use of the kitchen requires one or more kitchen personnel. Please indicate anticipated personnel required for your event.
Date of Proposed use
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Start time
Time
:
End Time
Time
:
Is this a repeating event?
If repeating, what is the frequency?
Estimated Number of Attendees
Your answer
Estimated parking spaces needed - If you anticipate more than 5 parking spaces, please submit a parking plan to hredding@pacificesd.org.
Your answer
Number of Chairs needed
Your answer
Number of Tables needed
Your answer
Estimated revenue from the proposed event.
Your answer
Revenue will be used for ...
Your answer
Fees
Fees charged by Pacific Elementary School District are related to the purpose of your organization/event.
Please read below and select the category that best describes your organization/event.
I and/or the organization applying for use fit in the following category:
Payment Information
Payment for facility use is due one week before your event. Deliver payment to the school office or by post to Pacific Elementary School, P.O. Box H, Davenport, CA 95017. Cash or Check only (no credit/debit cards accepted). All fees including wages for kitchen and/or custodial staff must be paid in advance. Make checks to Pacific Elementary School.
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