FACILITIES USE REQUEST APPLICATION
DISTRICT REQUEST
CA EDU §82537 et seq. Civic Center Act / Administrative Policy 6700
Page 1 of 4
* COMPLETED REQUESTS MUST BE RECEIVED BY CAMPUS EVENTS OFFICE A MINIMUM 3 WEEKS PRIOR TO THE EVENT.
FACILITIES SERVICES CAMPUS EVENTS OFFICE: 661-722-6562
AVC Organization / Group
Contact Person (Responsible During Event)
Street Address
City State
Zip Code
Work Phone Number
Cell Phone Number
Fax Number
Email Address
Name of Event:
Facilities Requested:
_____________________________________________________________________________________________________
Day: Date: *Use Additional Notes for Rehearsal times.
Set-Up Begins at: Event Begins at:
Event Ends at: Room Use End Time:
Number of attendees: Do you need chairs? Yes No
Will an admission charge or collection be made? Yes No Price of tickets (if applicable): $_
Will donations be accepted? Yes No If Yes, how are proceeds used? $_
Does Event directly benefit the District or student group? Yes No If Yes, which one?
Do your attendees have any special needs? Yes No If Yes, explain:
Do you need tables? Yes No Rectangular _____ Round Tables _____ Other (Use Diagram) _____
Do you need technical support? Yes No *Techs are scheduled ½ day prior to event start time.
If additional time is needed, please indicate the time you would like the tech to arrive:
Podium: Yes No Microphone(s): Yes No Amount/Types:
* INTERNET service may be received by Wi-Fi. Auxiliary Services does not provide laptops, tablets or other devices.
List additional District personnel required (additional charge):
List equipment required (additional charge):
List storage space required (additional charge):
STATEMENT OF INFORMATION: The undersigned, as a duly authorized representative for User states that, to the best of
his/her knowledge, the District property for use of which application is hereby made will not be used for the commission of
any crime or any act which is prohibited by law.
REQUESTER ACKNOWLEDGES THEY HAVE READ AND AGREE TO ABIDE BY THE TERMS AND CONDITIONS OF THIS REQUEST,
AND THAT THEY ARE COMPLETING AN APPLICATION WHICH IS PENDING APPROVAL.
Responsible Party’s Signature: Date: _______________
Dean/Director’s Signature: Date: _______________
Printed Name(s) and Title(s): _______ _ _____
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FACILITIES USE REQUEST APPLICATION
DISTRICT REQUEST
CA EDU §82537 et seq. Civic Center Act / Administrative Policy 6700
Page 2 of 4
ADDITIONAL NOTES / MAP / SETUP DESCRIPTION:
FOR DISTRICT CAMPUS-EVENTS USE:
Date Application Received: ____________ User is: Free Use Direct Cost Fair Rental Value
Assigned Personnel and Cost:
Assigned Equipment and Cost:
Assigned Storage and Cost:
Rental Cost: ________ Total Cost for use of Facilities: _____________ Date payment due:
Approved by (print & sign): ________________________________ Date:
FACILITIES USE REQUEST APPLICATION
DISTRICT REQUEST
CA EDU §82537 et seq. Civic Center Act / Administrative Policy 6700
Page 3 of 4
TERMS & CONDITIONS FOR USE OF DISTRICT FACILITIES:
1. GENERAL
1.1. No activity which may interfere with the educational
program of the campus or the District will be approved
or permitted. Any violation of these Administrative
Regulations, Board Policies, or other State or local law by
any User, or member of the User, during use shall be
sufficient cause for denying further or continued use of
facilities or grounds by the User or member. No User
may obtain a Use Agreement of more than one year in
duration or in a manner that constitutes a monopoly for
the benefit of any person or User.
1.2. Intoxicants, narcotics or tobacco products shall not be
permitted.
1.3. Juvenile organizations must have adequate adult
sponsorship and supervision.
1.4. Facilities and grounds shall not be available at any time
which might interfere with regular functions of the
campus, and said time will be determined by the
President or person designated by him/her.
1.5. Facilities and grounds must be protected from damage
and mistreatment, and ordinary precautions must be
maintained. User shall be responsible for the condition
in which facilities and grounds are left. At the conclusion
of each period of use, the User shall pick up any trash,
turn off lights and other utilities, put away equipment
and, if applicable, lock or secure the facilities and
grounds. Should any District property be damaged or
abused beyond normal wear, such damage will be paid
for by the User involved and shall be sufficient cause for
cancellation of future meetings or functions.
1.6. If a User requires extra chairs or tables etc., other than
those which are assigned to the facility requested, a
charge shall be made for moving chairs, etc. from other
locations, as shown in the Fee Amount.
1.7. No District furniture or equipment shall be moved
except as authorized by District personnel.
1.8. No alterations or additions shall be made to any facilities
or grounds without first submitting a written request
describing in detail the proposed change and receiving
written approval from the President to proceed. If
approval is given, it is the responsibility of the User to
return the facilities or grounds to its original condition.
Failure to do so will result in the District billing the User
for the costs incurred by the District in restoring same
and is cause to cancel future meetings or functions of the
User.
1.9. All draperies, hangings, curtains, drops and all decorative
materials/props used within or upon the buildings or
grounds shall be made from a nonflammable material or
shall be treated and maintained in a flame-retardant
condition by means of a flame-retardant solution or
process approved by the State Fire Marshal.
1.10. No animals of any kind are allowed on District grounds,
except for certified service animals.
1.11. The User representative shall keep a copy of the
application and related documentation on-site during
use of the facilities and grounds.
1.12. No payment shall be made directly to an employee of the
District. Tips and gratuities for any District employees
are strictly prohibited.
1.13. User using facilities and grounds shall not imply, indicate
or otherwise suggest in any way that their use and/or
any related activities are connected or affiliated with, or
are endorsed, favored or supported by, or are opposed
by the District, unless approved in writing by the
President or designee. No signage, flyers or other
material may reference the District, any campus name,
logo or mascot, except to indicate location of the User’s
event, unless approved in writing by the President or
designee.
2. BUILDINGS
2.1. No preparation of any kind shall be used on floors by
Users using the buildings for dancing.
2.2. Shoes with cleats or plates, or rubber soles or heels
which mar or mark the floor are not permitted in
buildings.
2.3. At no time shall smoking be permitted in classrooms, or
any other facilities or grounds.
2.4. The number of tickets sold for any event shall not exceed
the regular seating capacity of any auditorium or other
facility.
3. GROUNDS
3.1. Knives or sharp instruments shall not be carried on the
grounds.
3.2. Activities that involve constant physical contact (tackle
football, karate, boxing, etc.) shall not be engaged in on
District property without special permission from the
President.
3.3. Hardball playing shall not be permitted unless direct
supervision of an organized baseball team is provided.
3.4. Horseback riding shall not be permitted on the grounds.
3.5. Skating and skate boards on the grounds are prohibited.
3.6. Climbing on buildings, fences or other facilities not
intended for climbing is prohibited.
3.7. Firearms, including pellet guns, BB guns or sling shots are
prohibited on the grounds.
3.8. Archery shall not be permitted on the grounds.
FACILITIES USE REQUEST APPLICATION
DISTRICT REQUEST
CA EDU §82537 et seq. Civic Center Act / Administrative Policy 6700
Page 4 of 4
3.9. Riding of bicycles (other than supervised bicycle
activities), tricycles, scooters, motor scooters, go-carts
and automobiles (except where specifically authorized)
is not permitted on the grounds.
3.10. Running of model cars or flying of model planes or
drones is not permitted on the grounds.
3.11. Grounds shall be left in good order at the conclusion of
any authorized activity and property shall not be
misused, used for a use other than their intended use, or
destroyed.
3.12. Golf practice shall not be permitted on the grounds.
4. CUSTODIAL SERVICES
4.1. Free custodial services may be provided to those Users
qualifying under the free-use provisions of the Board's
policy only in cases where the custodian normally would
be at the assigned area or site as part of his/her regular
assignment. Additional time will be charged at the rate
indicated in the Fee Amount.
4.2. The assigned custodian, at the direction of the
Maintenance and Operations office will be responsible
for verifying the User's authorization to use the facility
or grounds, making the necessary arrangements to
accommodate the meeting, cleaning and returning the
facility to proper condition for District use, reporting any
deviations or departures from the established rules,
regulations and policies, and performing all services
necessary for the intended use.
5. FURNITURE, EQUIPMENT AND TECHNOLOGY
5.1. No electrical, mechanical, or other equipment may be
brought on to the grounds without the prior approval of
the President or designee. In the event equipment is
allowed to be brought onto the grounds, the District
shall not be liable for any damage to the equipment or
to the facilities or grounds by use of such equipment.
5.2. District-owned equipment, furniture and technology
may be used by Users on the following conditions:
5.2.1. Allowing use of any equipment, furniture or
technology is at the sole and absolute discretion of
the District and may be denied for any or no reason.
5.2.2. Requests for use of equipment, furniture or
technology shall be included on the facilities use
application form.
5.2.3. The person who has jurisdiction over the
equipment, furniture or technology shall review all
applications requesting use and shall recommend
approval or denial of the requested use.
5.2.4. District may charge for use of equipment, furniture
or technology as set forth in the Fee Amount, or as
otherwise determined by the President or
designee. Users shall pay for personnel needed to
set up equipment, furniture or technology, as set
forth in the Fee Amount.
5.2.5. The User assumes the responsibility for such
equipment, furniture or technology supplied and
agrees to repair or replace any equipment,
furniture or technology which might be damaged,
lost or stolen while under the control of the User.
5.2.6. The User requesting the use of equipment,
furniture or technology certifies that a qualified
person will operate it, subject to approval of the
Maintenance and Operations office. The District
may require the user to pay for personnel needed
to operate certain specialized equipment, furniture
or technology, as set forth in the Fee Amount.
5.2.7. Users using facilities which include a stage shall not
remove or displace any furniture, pianos, or other
stage equipment or make changes in curtains,
lights, ceiling pieces, backdrops or other props
(including changing the counterweight system or
switchboard hookup) without prior approval from
the Auxiliary Director or designee, and then, only
under the direct supervision of the employee in
charge. When the stage is to be used, full details in
writing of personnel and equipment needed must
be furnished in advance, including, but not limited
to: lights, curtains, dressing rooms, ticket sales,
stagehands, ushers, etc.
5.2.8. Furniture, equipment or technology available for
use will be only that which is already available at
the site requested. Furniture, equipment or
technology is not available for use off District sites.
5.2.9. Facilities with specialized equipment, such as
computer laboratories, science laboratories and
ceramics studios, shall not be available for use
under the Civic Center Act.
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