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Facility Use Request
This request form allows staff or people from the community to schedule use of your facilities. As forms are received then maintain a master log including each facility location you have available to create a usage schedule.

Free Sample Template
Format: Word PDF
# of Pages: 1
Printable: Yes

Facility Use Request TemplateForm 2758
Format: Word PDF
Category: School, Administration
Type: Request

Facility Use Request

Date: ___/___/_____

New Request

Revising Previous Request

Name of the Event: _____________________________________________________________________________

Number of Attendees: ________________

Contact Person: ________________________________________________________________________________

Phone Number: ________________________________________________________________________________

Email Address: _________________________________________________________________________________

Dates of the Event:

Start Date and Time: ___/___/_____ at ___:___ AM / PM

End Date and Time: ___/___/_____ at ___:___ AM / PM

Please list all of the facilities that you will require for your special event: __________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Additional accommodations or requests: ____________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Billing Information:

Name: ________________________________________________________________________________________

Address: ______________________________________________________________________________________

City: _______________________________________ State: ___________ Zip Code: _________________________

Account Type: [___] Visa [___] Master Card [___] AMEX [___] Discover

Cardholder Name: ______________________________________________________________________________

Account Number: _______________________________________________________________________________

Expiration Date: ___/___/_____ CVV2 Code: _____