Mobile Career Center Reservation Form

Mobile Career Center Reservation Form
Organization Name/Contact Person*
(Organization Requesting Mobile Career Center)
Contract Person Address
Contract Person Phone Number
Contract Person Email*
example@example.com
Event Name
Event Information
Please include detailed information regarding what the Center will be used for and how many participants you expect to attend.
Event Date

MonthDayYear
Date
Event time
(beginning and end)
Event Address
Include a brief description of where the center will be set up.
Event Details
(Please include detailed information regarding what the Center will be used for and how many participants you expect to attend).
I certify that the Mobile Career Center will not provide any service contrary to any local, state, or federal law or ordinance. There will be no tobacco, food, drink, or alcohol used in the Mobile Career Center. Additionally, no person under the age of 13 shall use the Mobile Career Center without proper supervision.

I certify that no software containing known malicious components will be installed on the Center’s computers. Northwest Georgia Regional Commission is not responsible for loss of data or information.

I certify that the facilities where the Mobile Career Center will be located are able to accommodate the size of the Center (height, 13 feet; length, 38 feet).

I understand that any content to be provided (job search, resume, assessments, etc.) shall be provided by me or my staff. The NWGRC will not provide such services (unless previously arranged).
Initial to certify to the above*

Clear
By signing below, I certify that all information provided herein is true and correct.*

Clear
Date:

MonthDayYear
Date
Staff use only
Please return to Terri Morgan at tmorgan@nwgrc.org or fax to 706.802.5567
Should be Empty: