Facilities Request Form

Facilities Request Form
NAME OF ORGANIZATION*
NAME OF REPRESENTATIVE OF THE ORGANIZATION*
PHONE NUMBER OF THE REQUESTOR*
Please enter a valid phone number.
EMAIL ADDRESS OF THE REQUESTOR*
example@example.com
DATE YOU WANT TO USE THE FACILITY*

MonthDayYear
ROOM(S) REQUESTED*
TIME OF DAY BEGINNING*

Hour Minutes

AM/PM Option
ENDING TIME*

Hour Minutes

AM/PM Option
PLEASE DESCRIBE THE PURPOSE FOR THE REQUEST*
PLEASE DESCRIBE ANY SPECIAL CIRCUMSTANCES (EQUIPMENT NEEDED, SOUND SYSTEM, ETC.)*
I WILL PROVIDE PROOF OF INSURANCE AS REQUIRED*

YES
I HAVE READ AND UNDERSTAND THE FACILITIES USE POLICY AND OUR ORGANIZATION WILL ABIDE FULLY BY THE POLICY*

YES - VIEW POLICY HERE: https://prattsburgh.sharepoint.com/:b:/s/WebsitePolicies/EVsGzHNR6p1NjPJ_YVuzRWYBxqHEvdqXjSwETS5qFV6Qbw?e=UbeIAN
Should be Empty: