Building Use Request Form
Please use a separate form for each facility requested
* Required
Email address
*
Your email
Please confirm your email address below:
*
Your answer
Organization Name:
*
Your answer
Contact Person:
*
Your answer
Phone number:
*
Your answer
Day(s) Requested:
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Required
Date(s) Requested:
*
Your answer
Time Needed:
*
Please include setup and take down time
Your answer
Will Concessions be sold
*
Yes
No
If Concessions are being sold list types:
Your answer
School:
*
Check only one per form
Blueberry Hill Elementary School
Center Elementary School
Wolf Swamp Road Elementary School
Glenbrook Middle School
Williams Middle School
Longmeadow High School
Facility Requested:
*
Check all that apply
Gym
Cafeteria
Auditorium
Classroom
Multi purpose room
Library
Pool
Required
Number of Participants/Attendees:
*
Your answer
Description of Event:
*
Please provide a detailed description of the event
Your answer
Add'l notes, comments, or items needed:
Your answer
A copy of your responses will be emailed to the address you provided.
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