JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Building Use Form
**This form must be submitted TWO WEEKS prior to your event in order to receive approval **
Any forms submitted after the two week window cannot be guaranteed space.
If the space is UNAVAILABLE, you will receive a separate email from the Student Activities & Engagement Coordinator.
Questions? Email the Student Activities & Engagement Coordinator, William Jeffcoat.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name of Organization Sponsoring Event/Activity
*
Your answer
Event Title (this is how it will show up on the calendar)
*
Your answer
Event Description
(Meeting, ceremony, etc.)
Your answer
Sponsor's Name (point of contact for activity)
*
Your answer
Start Date of Event
*
MM
/
DD
/
YYYY
End Date of Event
*
If event is only on one day, please list the same date here.
MM
/
DD
/
YYYY
Event Start Time
*
Please note that on your confirmation email, the setup and start time will be the same because of the way the LCPS scheduling system works. You will be granted one hour prior to your start time for setup. If you need additional time, please coordinate with the Student Activities & Engagement Coordinator.
Time
:
AM
PM
Event End Time
*
You will be guaranteed an hour of breakdown time. If you require a longer amount of time, please email the Activities Coordinator.
Time
:
AM
PM
Space Requested
*
Your answer
Set-up and take-down needs
*
Items marked with a * may require additional training on your part.
Screen
Microphone
Trash cans
Projector Access
Tables (specify number below)
Chairs (specify number below)
I do not require any additional materials and will provide my own.
Other:
Required
If you requested tables and/or chairs, please tell me how many you are requesting (we will do our best to accommodate and I will let you know if it is an issue)
*
Your answer
Do you require custodians for your activity?
*
For example, moving equipment or cleanup is required, or if large numbers of people attend.
Yes
No
If you answered yes to custodians, please list the times you would like custodians present. Custodians are needed for cleanup and unlocking the building. If you do not have a key or access to the building, you will likely need custodial support. All of this is at discretion of the Principal.
*
Your answer
Person Submitting the Application
*
If more than one person, separate names with a comma
Your answer
Contact Person's Email
*
Your answer
Additional Comments/Recurring Event Information
If this is a recurring event, please list other dates here (i.e. dates or recurrence schedule, like "Second Tuesday of the month")
Your answer
LCPS Special Events Form: If this is a large activity (tailgate, festival, open mic night, coffeehouse, school-wide or community event that requires vendors or contracts with an outside group, etc.) involving the whole school and/or community and potential risk, please complete the LCPS Special Events application. This is both a hard copy (leave in the Activites Coordinator's mailbox) and this Google Form:
https://docs.google.com/forms/d/e/1FAIpQLSc7NcaYeVhcsYzDbf_ay8Mq9ZelzW8WfHkZ1B-O702cVc4TMw/viewform
*
Yes, I am hosting a special event and will be sure to complete the hard copy form found in the PFHS Activities Schoology Group and the Google form above
No, this event is not a special event and only this form is needed.
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Loudoun County Public Schools.
Report Abuse
Forms
