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Facility Request Form

Please complete the below form to request usage of facilities.  You will receive notification of approval once your request is reviewed. If approved, you are responsible for ensuring the facility is left clean and in order.  Any damages to facility will be charged to you.

No unauthorized usage of facility is allowed.

Some facilities may require additional documentation prior to approval.

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1
Facility Request
Nameyour full name
Person Responsible for Event
Description of Activity
Date of Activity
Start Time
End Time
Campuspick one!
What Room are you Requesting?
Please Check Yes or No to All That Apply for Your Request
YesNo
A/C Needed
Audio/Visual/Technical Needs
Parking Committee Needed
Security Team Needed
Set Up Required
Clean Up Required
Please explain in detail for each of the items you checked yes!
0 /
Facility PoliciesPlease check each box that you agree and will adhere to the policy
Agree
Bag trash and put in dumpster
Dispose properly of unused food
Clean and return kitchen utensils
Clean kitchen and lunchroom floor
Report ALL Maintenance and Repair Items
Turn of ALL lights and Lock ALL doors
Clean floors and vacuum
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