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Facility Use Request Form
Please complete this form to request the use of facilities in Springfield Elementary School.
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* Indicates required question
Organization or community member making request (full unabbreviated name of organization or first & last name of community member)
*
Your answer
Email address:
*
Your answer
Facility requested:
*
Gymnasium
Cafeteria
Stage (includes use of cafeteria when requested)
Media Center
Athletic Field (includes baseball diamond & adjacent open field)
Playground
Courtyard (specific to the area between the gym and the primary wing)
Courtyard (specific to area behind the school near the playground)
Parking Lot
Bus Loop (includes main entrance steps & sidewalk)
Required
Date of the event:
*
MM
/
DD
/
YYYY
At what time will setup occur?
*
Time
:
AM
PM
What time will the event start?
*
Time
:
AM
PM
What time will the event conclude?
*
Time
:
AM
PM
Purpose of the event:
*
Your answer
Name of person in charge of the event:
*
Your answer
Estimated attendance:
*
Your answer
Equipment requested (check all that apply):
folding chairs (indicate quantity below)
folding tables (indicate quantity below)
microphone & speaker
projector & screen
Equipment quantities (if required)
Your answer
Please provide any additional information regarding this event as needed (including, but not limited to, seating and room arrangements, equipment not listed above such as cones, bleachers, mats, etc...):
Your answer
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