Facility Use Request

Facility Use Request
Group Type
Organization Name
Contact Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Purpose of Event
Date(s) of Event
Open to Public?
Facility
Areas

Other
Equipment Needed
Time Building to be Open:
Time Building to be Closed:
Additional Comments
I have read and agree to the terms necessary for the use of the USD 239 facilities and equipment. I further assum personal responsibility for compliance of the organization/group named above in regards to the terms attached to this request
Signature
Date

MonthDayYear
Date
Should be Empty: