City Space and Services Request Form

Use this form to request an in-kind appropriation from the City of Oxford through the use of City-owned space, facilities, equipment, staffing, or services. Please provide complete and accurate information about your organization, the assistance requested, its proposed use, and the expected public benefit to Oxford residents.

Applicants must submit three years of audited financial statements, proof of current 501(c)(3) status, a current organizational budget, and the most recent Form 990.

The committee chair will conduct an initial review. Requests that meet the eligibility requirements will be presented to the full Appropriations Review Committee. The committee will review each request and make a recommendation to the City Council. A recommendation does not guarantee approval; the City Council has final authority to approve, deny, or modify a request.

If approved, the organization must sign an agreement covering the authorized use of City resources, applicable dates, organizational responsibilities, and required reports. Assistance is subject to availability and the terms of approval. Submitting this form does not reserve City space or commit City staff, equipment, or services.

Individual Submitting the Request

First NameLast Name

Organization Name

Organization Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

As part of my Request submission, I am uploading the following: three (3) years of audited financial statements, 501c3 determination letter, current organizational budget, most recent form 990.

File Upload

Type of Assistance Requested

Describe the City space, equipment, staffing, or other services requested.

Identify each facility, location, item, or service requested. Include quantities, estimated staffing hours, and other details that will help the City evaluate the request. If requesting a fee waiver or reduction, identify the applicable fee and the amount you are asking the City to waive.

Requested Dates and Times

Include all dates and times when City resources would be needed, including setup, the event or activity, and cleanup. Identify any flexibility or alternate dates.

Specific Purpose and Proposed Use of City Resources

Explain how your organization would use the requested space or services and how that assistance would support the event, project, or program.

Estimated Attendance or Total Number of Participants

How many Oxford residents will be served as a result of the requested assistance?

Estimated Value of City Assistance Requested, if Known

Provide any available rental rates, service estimates, or other information supporting the estimated value. If unknown, enter “Unknown.” The City will determine the estimated cost or value of the requested assistance during its review.

Please describe the public benefit to the City of Oxford.

Explain what service, activity, or result the public will receive through the requested use of City resources. Identify who will be served, how Oxford residents or the public can participate or access the benefit, and the number of people expected to benefit. Include any admission charges, participation fees, or eligibility restrictions. Describe how the proposed use serves a public purpose.

Please detail measurable goals and expected outcomes.

Describe the specific results you expect to achieve and how you will measure them. Include measurable targets, such as the number of Oxford residents served, activities completed, or services delivered, and when you expect to achieve them.

List other funding sources, including organizational funds committed to the event, project, or program.

List other funding sources for this project, including grants, donations, fees, partner contributions, and funds your organization will contribute. For each source, provide the amount and indicate whether it is confirmed, pending, or proposed. If the project has no other funding, please say so.

Indicate whether this is a one-time request or whether you expect to request City funding again in future years. If recurring, a new form must be submitted each year; recurring requests are reviewed annually, and future funding is not guaranteed.

Does the event, project, program, or service duplicate services already provided by the City or another organization?

If yes, explain the overlap, the need for additional services, and any coordination with existing providers.

Please allow up to three weeks after submitting a complete request for the committee’s full review and response. Organizations should submit requests at least 90 days before the requested use of City space or services to allow time for review, scheduling, and processing.

By entering my name and submitting this form, I intend to sign it electronically. Federal law generally provides that a signature or record may not be denied legal effect solely because it is in electronic form (E-SIGN Act, 15 U.S.C. § 7001).

By signing, I certify that I am authorized to submit this request on behalf of the organization and that the information and documents provided are true, accurate, and complete to the best of my knowledge. I understand that submission does not guarantee approval or reserve City resources and that any approved assistance must be used only for the authorized purpose and in accordance with the applicable agreement.

Signature