Saturday, November 21st, 2009

 
 
SCCS Building Use Form
Please fill in all areas of the form below
Your Name
 

Please enter YOUR name
Organization Name
 

Please enter the name of your Group, Club or Organization
Event Name
 

Please enter the name of your event
Date(s) Requested
 

Please enter the date(s) of your event
Weekday(s)
 


Please enter the day(s) of the week you would like to reserve
Time of reservation
 

Please enter the begin and end times you would like the room reserved for
Event Time
 

Please enter the ACTUAL begin and end times of your event
Description
 

Please describe the nature of your event
Facility Needed
 
Equipment Needed
 



Please enter any additional equipment needed
Room Requested
 
Room # Requested
 
Estimated Number of Participants
 
Supervised by
 

Please enter name of chaperone(s)
Will Admission be charged?
 
If so, how much
 
Proceeds will be used for:
 
Contact Name
 
Contact Title within the organization
 
Address of Organization or Contact
 
Contact Phone Number
 
Contact E-Mail Address
 
Insurance Information