Request for Use of School Facilities or Equipment
* Required
Facility Request Fees for Outside Groups
I understand that there is a fee associated with requesting access to school facilities for groups not associated with the school district.
*
Yes
No
Purpose of Request:
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Your answer
Group Making Request:
*
Your answer
Person Making Request:
*
Your answer
Requester's E-mail
*
Your answer
Address:
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Your answer
Home Telephone:
Your answer
Work Telephone:
Your answer
Cell Phone:
Your answer
Work Fax:
Your answer
Facility and/or Equipment Requested:
*
*PLEASE NOTE - If selecting the Kitchen, the use of the listed appliances requires that your group/organization have a member of the DCS food service staff on duty. Your group/organization may be responsible for reimbursing the District for the hours that employee is on duty.*
Gym 1
Gym 2
Locker Rooms
Athletic Fields
Track
Big Blue
Auditorium
Sound System
Projector/Screen
DVD Player
Internet Access
Elementary Cafeteria
High School Cafeteria
Cafeteria Kitchen – use of power, serving line, small refrigerator, and microwave ONLY
Cafeteria Kitchen – use of above, plus ovens, stove, and/or dishwasher
Elementary Art Room
High School Kitchen Classroom
High School Sewing Classroom
Other:
Required
Date Requested for Use of Facility and/or Equipment:
*
Your answer
Start Time
*
Please include AM/PM.
Your answer
End Time
*
Please include AM/PM.
Your answer
Describe Any Special Set-Up Requested:
*
Your answer
School Contact Person:
*
Your answer
Phone:
*
Your answer
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