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Pleasant Hill Learning Campus Facility Use Request
Facility Use Request Form for Non-Curricular and Non-School Organizations
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* Indicates required question
Email
*
Your email
Individual/Organization Requesting Facility (Responsible Party)
*
Your answer
Contact Name, Address, and Phone Number
*
Your answer
Email
*
Your answer
School Affiliation (Which school does your student attend?)
*
Elmont
Logan
North Fairview
Northern Hills
West Indianola
Seaman Middle School
Seaman High School
None
How many gyms are you currently reserving across the district?
*
0
1
2
3
4
Event Title
*
Your answer
Purpose & Event Description
*
Your answer
Will attendees consist of 50% or more Seaman School District patrons?
*
Yes
No
Area Requested
*
Classrooms
Multipurpose Room
Other:
Date(s) and Time(s) (Beginning and Ending)
*
Your answer
Is this a recurring event? If yes, explain
*
Your answer
Number Attending
*
Your answer
Equipment Requests
*
Your answer
Other Needs
*
Your answer
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This form was created inside of Seaman USD 345.
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