JHS Building Use Form 2017-2018
Name of organization *
Your answer
Type of event *
Your answer
Date and Time Information
Start date
MM
/
DD
/
YYYY
End date
MM
/
DD
/
YYYY
Day of the week *
Please indicate the day of the week this event takes place. If your event will take place over multiple days check all the days that apply.
Required
Starting time of event *
Use time format (ex 8:00 AM) and indicate AM/PM
Your answer
Ending time of event *
Use time format (ex 8:00 AM) and indicate AM/PM
Your answer
Time building to be opened *
Use time format (ex 8:00 AM) and indicate AM/PM
Your answer
Time building to be closed *
Use time format (ex 8:00 AM) and indicate AM/PM
Your answer
Rooms requested *
Please check all areas needed during you event. If you are requesting to see if one of these locations are open please indicate ONLY the one you are requesting to use.
Required
Anticipated Attendance *
Your answer
Tables Needed
Number of tables needed: *
Your answer
Chairs Needed
Number of chairs needed: *
Your answer
Use of the school kitchens must be approved by the Food Service Director. Please call (616) 457-2400 for approval prior to the submission of this form.

Use of the technical equipment in the high school auditorium must be approved by the theatre Director. Please call (616) 457-3400 for approval prior to the submission of this form.

Special Lighting or Sound Needs
Your answer
Auditorium dressing room needed:
Auditorium make-up room needed:
Custodian needed: *
Additional custodial information
Use this space for any additional needs. Submit a diagram to bvendal@jpsonline.org after submitting this form (if needed).
Your answer
On behalf of the organization listed, I, as the sponsoring adult, agree to be responsible for the rental and fees associated with the use of JPS facilities. I further accept the responsibility for any damage to the building, equipment, or grounds. I will leave the facility in a satisfactory condition, immediately report any accident or problem, prohibit smoking, and remain in the building until all participants have left. I understand that building use requests are to be submitted at least 10 days in advance and school activities take priority over any other activities. The Board of Education policy regarding building use is available at the Administration Office. Failure to comply with this agreement and board policy will result in a loss of usage privilege.
Name: *
Your answer
Address: *
Your answer
City: *
Your answer
Zip code: *
Your answer
Phone number: *
(xxx) xxx-xxxx
Your answer
Email address *
Your answer
Signature *
Required
Cancellation Policy
If you need to cancel/change this event, please contact Jenison Public Schools using the following email.

bvendal@jpsonline.org.

Submit
Never submit passwords through Google Forms.
This form was created inside of JPS. Report Abuse - Terms of Service - Additional Terms