Jr/Sr High Building Facility Use Form

Jr/Sr High Building Facility Use Form

Name of Company: 

Name of person submitting the request:


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:


Not Approved 

Security Measure