FACILITY REQUEST FORM
This is an internal form – requestor must be a college/district employee. This form must be completed
at least two weeks prior to the event. Requests may take 2-3 business days to process. Requestor will
receive confirmation once dates and times have been reserved by scheduler. Requestor is responsible for
coordination of needed services.
Approvals – Requestors route completed form via DocuSign for signatures, then send signed form to scheduler.
________________________________ ______________
Department Administrator Signature Date
________________________________ ______________
VPI/VPSS/President Signature Date
________________________________ ______________
Office of Admin Services Approval
Date
For Scheduler Only:
Date Received: ________________________
Received by: __________________________
Processed Date: _______________________
Room(s) Assigned: _____________________
(Required for Sponsored Events only)
Date of Request: _______________________________________________________________________
REQUESTOR INFORMATION:
Requestor Name: ________________________________ Department/Area: ______________________
EVENT INFORMATION:
Event Name: _____________________________________ Expected Attendance: ______________
Event Description: _______________________________________________________________________
_______________________________________________________________________
Event Type: Internal Event (part of college/district/district foundation)
Sponsored Event*
(internal department/office hosting external organization)
*If sponsored event, please state organization the department is hosting on campus.
(Organization will be required to provide proof of insurance, W-9, and sign a Facilities Use Agreement prior to event.)
_______________________________________________________________________
Room(s) Desired: _______________________________________________________________________
Day(s)/Date(s) Needed:
_____________________________________________________________________
Time Requested: From: ___________________________ To: _________________________________
Special Instructions: _______________________________________________________________________
ADDITIONAL SERVICES - Please check any additional requirements that apply:
Reminder: Requestor is responsible for all coordination of needed services directly with department(s) concerned.
Parking Services (Parking Permits/Waiver) - Complete Event Parking Request Form**
**Email form to Office of Administrative Services- Program Specialist Brian Shively at brian.shively@missioncollege.edu.
Custodial Services (Room set up, clean up, etc.) – Submit Facilities Work Order***
***
Specific/detailed set-up instructions must accompany work order by diagram to custodial.
Catering Services - Contact Catering Coordinator, Marie Keith (marie.keith@missioncollege.edu)
Educational Technology Services (Classroom Projector, A/V, etc.) – Submit ETS Work Order
Other: ___________________________________________________________________________
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
