Facility Usage Application
Facility Use Application
Augusta Unified School District 402

**PLEASE READ BEFORE COMPLETING**
It is the responsibility of the requester to notify the Facilities Coordinator of cancellations or changes to the facility usage no later than 48 hours prior to the event.  Fees must be paid in full by the conclusion of the event however, in some cases, we may require prepayment.  If your request falls into a "prepayment" category, we will notify you accordingly.

A submission of the Facility Use Application with applicant's signature serves as follows:
I accept responsibility for the building usage fee, supervision, damage & compliance with USD 402 BOE requirements & have read the Facilities Use Agreement.

Your facilities use request will be under review upon completion of the following form.  You will receive notification of approval or denial via the email provided.


Questions concerning your request and/or reservation may be directed to Lori Norris at lnorris@usd402.com or by calling 316-775-5484 x1008.
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Email *
Name of Individual Handling Request *
Address *
Phone Number *
Purpose of Use *
Date/Dates Desired *
If dates are reoccurring please list ALL days & dates below: *
Time (From/To)
Building(s) being Requested *
Required

Room/rooms being Requested
(check all that apply) 
 *
Required
Special Requested Items
(check all that apply)
 *
Required
Will food or beverage be served at the event *
If yes, will USD 402kitchen equipment be needed, and if so, what equipment? *
Will admission be charged for this event? *
Other information:
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Acknowledgement of Policy Agreement



I hereby acknowledge that I have read and understood the Policy Agreement.

I understand the content, requirements, and expectations of the policy and agree to abide by it.  I am aware that if I have any questions or need further clarification, I can contact Lori Norris for assistance.


Signature *
Date *
MM
/
DD
/
YYYY
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