Facility Use Form - Facilities - District

Leslie Public Schools

Facility Use Request Form

Non-School Events cannot be requested more than 60 days in advance.

Organization Name

Date mm/dd/yyyy

Type of Organization K-12 Activity Non Profit Civic Group / Govt. Private Residents / Other Community Group / Church For Profit Group / Non-Resident /Commercial

Contact Person

Phone Number

Billing Address

E-mail Address

Activity Description

Requested Date(s)

Requested Start & End Time(s) building/doors will be unlocked a half hour before start time

Requested Facility / Building / Room(s)

Estimated # of Participants

Admission to be charged

Equipment & Services Needed

Please check all that apply and indicate number needed Podium with Mic Tables Chairs Cafeteria Tables Video Projector Projector Screen Choral Risers Pit Cover on Pit Cover off

# Tables Needed

# Chairs Needed

# Cafeteria Tables Needed

Notes and Other Requests

All Leslie Public Schools Properties are non-smoking areas.