Facility Request Form 2023-2024
*Special Notes!

Your event is important.  At times it may not be feasible to CONFIRM your request as quickly as you would like due to the nature of the request.  Other factors to be considered are; if additional approval/staff is necessary, if it is during a high volume time of year, how many other requests are in front of yours, etc.  A backup plan is always recommended.  

You must be ready to submit the insurance requirement of two million dollar coverage at the time of your request.  *Excludes users of outdoor green spaces.

Payments including deposits will only be accepted via credit card in person by appointment.  If a check is preferred please tell the facilities scheduler so appropriate processes may be implemented.
Sign in to Google to save your progress. Learn more
Group/Organization Name *
Contact Person Name *
Event/Activity *
Please write brief description of the event.
How Many Expected in Attendance?  Participants and Spectators if Applicable. *
Date(s) Requested *
Please use exact dates, not days.  You can request multiple dates here.
Building Requested *
Will there be another Contact or Site Representative? *
Room/Space Requested.  If requesting green space, please state which school and area you want.  *
Contact Person Street Address (Do NOT Include City or Zip) *
City and Zip Code *
Are you a Current ACSD Employee? *
Contact Person Email.  District staff, please do not use your work email for personal event. *
Contact Person Phone *
Starting Time of Actual Event *AM/PM* *
Do NOT include setup/teardown time here.  NOTE AM or PM PLEASE.
Time
:
Setup Time (Access to Facility) *AM/PM* *
Time
:
End Time of Actual Event *AM/PM* *
Time
:
Teardown (When You Leave Facility) *AM/PM* *
Time
:
Any Other Information Regarding Your Event (Equipment Requested, etc). *
Date You Must Hear Back *
Please list the latest date you can wait to hear back on availability.     This is simply a measure to ensure a timely response.  
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Ankeny Community School District. Report Abuse
Google Forms