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OSD Facility Use Agreement
Please read
OSD Facility Use Guidelines
before filling out the form.
This form represents a scheduling request ONLY. You will receive a confirmation via email if your request is approved. Please fill out this form TWO WEEKS before your event date, and please allow 7-10 days for your confirmation.
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* Indicates required question
Name of person requesting facility rental:
*
Your answer
Who will be the on-site responsible party?
*
Your answer
Address of responsible party:
*
Your answer
City, State and Zip
*
Your answer
Primary phone of responsible party
*
Your answer
Primary Email
*
Your answer
Organization name
*
Your answer
Event date
*
MM
/
DD
/
YYYY
Requesting more than one date? Please list the dates and times below.
Your answer
Event start time (start time includes set up)
*
Time
:
AM
PM
Event end time (end time includes clean up)
*
Time
:
AM
PM
Short description of event
*
Your answer
How many people expected in attendance?
Your answer
Facility requested:
*
Kuenzi Hall Outreach
Panther Pool (Applicant must provide lifeguard)
Main gym
Auxillary Gym
Clerc Conference
Cafeteria
Library
NTID Conference Room
Panther Den
Panther Field
Peterson Hall
Lindstrom Hall
Other:
Required
Fridge Needed?
*
Only Main Gym, Panther Den, Peterson Hall, and Lindstrom Hall have the fridges available. If you pick one of these facilities, you may indicate here if you need to use the fridge for your event.
Yes
No
Food and Beverage (Bringing own food/beverage OR Need lunch tickets x how many) Lunch tickets are $4.00 each.
*
Your answer
Rent-able services (please select all that you will need)
IT Technician ($60/hr)
Custodian ($74/hr)
On-site Supervisor (if we have to provide) ($90/hr)
Security ($90/hr)
Table and chair set up/take down ($70/hr)
Rent-able items (please select all that you will need)
6 ft table ($5 each)
Folding chairs ($1 each)
Is this group affiliated with OSD?
Yes
No
Clear selection
Is this group part of the State of Oregon?
Yes
No
Clear selection
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