Name of Company:
Name of person submitting the request:
Email:
Date and Time To Be Used:
Facility to be used:
Elementary School
Jr/Sr High School
Equipment needed and what type
We will pay a cleaning fee (maximum $20 per hour)
Estimated Number of Hours:
We will pay a building use/rental fee if required
We agree to clean ourselves and understand if we do not do so to the satisfaction of the school, we will be billed for a cleaning fee
We agree to pay for any damages
We agree to pay building lock/unlock fee
Billing Name and Address:
_________________________________________________________________________________
To be filled out by administrator:
Name of Administrator:
Approved
Not Approved