Use of Facilities Request for HS Auditorium
Email address *
Name of Requestor *
Your answer
Mailing Address of Requestor *
Your answer
Phone Number of Requestor *
Your answer
Name of Activity *
Your answer
Organization *
Your answer
Start Date Facility Needed *
Please list the start date the facility will be needed
MM
/
DD
/
YYYY
End Date Facility Needed *
Please list the last day the facility will be needed. Please list the same date as the start date if it is only required for one day.
MM
/
DD
/
YYYY
Times Facility Needed *
Please list the times that the facility will be needed. Example: 7 pm to 9 pm each day.
Your answer
Admission Charge *
Building/Room/Facility Requesting *
* When the kitchen is used, a cook must be present for which a fee of $20/hour will be charged. **When an Organization rents a facility and it is necessary for a custodian to be present, a $20/hour fee will be charged. ALL FEES DUE PRIOR TO USE OF FACILITY.
Additional Information *
Please provide if any special equipment is needed or relevant information for the request.
Your answer
Principal's Approval (not to be filled out by requester)
Your answer
Superintendent's Approval (not to be filled out by requester)
Your answer
Rental Fee Waived - (filled out by Board Clerk)
Amount Due (filled out by Board Clerk)
Your answer
Date Available (filled out by Shane Stephenson ONLY)
On Calendar (filled out by Building Secretaries)
Comments (filled out by Building Secretaries)
Your answer
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