SCS Building Use Form
Name of Event
Phone Number(s) Where You May Be Reached
Number of people using the space:
1 - 5
6 - 10
11 - 25
Check all that apply
Projector & White Screen
For multiple dates, please scroll down to "Other Pertinent Information"
Multiple Dates Requested
List more dates for above listed activity
What area/classroom are you requesting?
please list all that apply
select best option
15 minutes before/after
30 minutes before/after
1 hour before/after
Which Calendar Should House This Event
SCS Staff (Only visible to SCS faculty and staff)
SCS Public (Should be visible to parents and community members via SCS website)
Both SCS Staff and SCS Public
"For Fee" Activities are subject to either a 25% building use charge which provides user with registration, payment collection and processing, room set-up if required and custodial service or a 10% fee which is used for building/custodial service. Please indicate below which service applies.
External Use/Full Service 25% Fee Applies
External Use/Custodial Service Only 10% Fee Applies
Internal Use Only/No Fee Charged For Program
Building Use Guidelines and Procedures Building Use: For Your Information Shelburne Community School welcomes and encourages after-hours use of the building and grounds. Because uses are many and varied, the following criteria have been established so that building maintenance/cleaning and upkeep may be facilitated in a timely manner, while maintaining and respecting the daily use of the facility’s primary use of educating Shelburne’s wonderful student population. Filling out a building use form is required BEFORE building may be occupied by any group for either internal or external use. Please do a brief visual inspection upon arrival in the area/classroom to ensure that area is left the way it was found. Familiarize yourself with emergency procedures and school/evacuation map located on the wall of each classroom/kiva.Safety Procedures:During a fire alarm, all building occupants are to take the closest exit and make their way to the basketball court (by Harbor Road entrance). Adults responsible for each group/student(s) should have a list of students, including their names and contact information of their parents which they bring along so that each student may be accounted for in a timely manner. During an “intruder alert”, an announcement will be made stating: “Clear the halls. Secure the building” This announcement will be repeated once. Adults should proceed in locking the door, turning off all lights, closing the shades and keeping everyone hidden from view as well as possible until the all clear is announced.In case of an accident or illness a custodian should be contacted immediately for cleanup. AVOID ANY PHYSICAL CONTACT with bodily fluids. All school materials (papers, student work, cubby notebooks, etc) must be treated as private and confidential. No students or adults should ever use or go through a student’s or teacher’s materials. Cancellation Policy: Please provide 48 hours notice for cancellation in order to avoid the custodial feel. I have read the following building use information.
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