Facilities Request Form
NAME OF ORGANIZATION
*
NAME OF REPRESENTATIVE OF THE ORGANIZATION
*
PHONE NUMBER OF THE REQUESTOR
*
Please enter a valid phone number.
Format: (000) 000-0000.
EMAIL ADDRESS OF THE REQUESTOR
*
example@example.com
DATE YOU WANT TO USE THE FACILITY
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
ROOM(S) REQUESTED
*
TIME OF DAY BEGINNING
*
Hour Minutes
AM
PM
AM/PM Option
ENDING TIME
*
Hour Minutes
AM
PM
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
SUBMIT
Should be Empty: