Alton CUSD #11 - Facility Use Contract Worksheet
Submission of request *
I understand that submitting this request does not guarantee that a contract will be granted and that submitting the request less than 30 days before the event will result in rejection of the request. In addition, I understand that the district may require a deposit prior to a contract being granted. Deposits will only be refunded when the district cancels an event.
Required
Alton School District events *
I understand that Alton School District events take precedence and that the District reserves the right to cancel a contract at any time. In the event of a cancellation, the District cannot be responsible for locating another venue for your event.
Required
Rules/Regulations and Fee Schedule *
Have you reviewed the rules/regulations and fee schedule available on our website - http://www.altonschools.org/index.cfm?page=2829 and do you understand that you must abide by the rules/regulations, ensure that anyone in the facility must abide by the rules/regulations, and that fees will be assessed based on this schedule? (Please note that the number of any personnel required by the district - sound/lights, custodial, security, etc - is solely at the district's discretion).
Required
Today's date *
MM
/
DD
/
YYYY
Facility requested *
Specific location requested *
If "other" above, please type location
Your answer
Your name/Organization's name *
Your answer
If "organization", representative's name and title
Your answer
Are you an authorized representative for the organization and allowed to sign contracts on behalf of the organization? *
Required
Email address for you/organization's representative *
Your answer
Billing address of requesting person/organization *
Your answer
Phone number of requesting person/organization (inc. area code) *
Your answer
Date(s) requested *
Your answer
Start time(s) *
Your answer
End time(s) *
Your answer
Purpose/event *
Your answer
Estimated number of people *
Your answer
Will you be able to provide a Certificate of Insurance? *
Required
If you are unable to provide a Certificate of Insurance, do you understand you will be required to purchase insurance at an additional cost? *
Required
Do you have any special needs, requests, services? *
This includes anything other than the room, including but not limited to tables, chairs, podiums, concessions/serve food-beverages, microphones, scoreboards, PA systems, technology needs, etc. Please note that any items not included in the request cannot be added at a later date.
Your answer
Due to the time needed to contact buildings and verify availability, please allow a minimum of two weeks for someone from the District to contact you regarding your request. Please note that it may take longer to receive a response during the months of August and September due to the start of school. Thank you.
Is there any other information you need to share regarding your request?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Alton Community Unit School District #11. Report Abuse - Terms of Service