Facility Use Request Form

Facility Use Request Form

This form is to be completed by individuals or groups applying to use/rent the North Carolina Cooperative Extension - Currituck County Center facilities. You will be contacted via email once your request has been approved. Please note reservations are accepted up to but not beyond six months in advance. For rentals, reservations are not confirmed until requests have been approved and deposit received.

* Required

Email address *

Your email

Please note additional facility guidelines in response to COVID-19

Applicant Name

Your answer

Phone Number ( cell) :

Your answer

Phone Number (work)

Your answer

Applicant Address:

Your answer

Is this use request for official county business? *

Yes

No

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