Fillable FACILITY USE REQUEST FORM IN-DISTRICT INDOOR FACILITY USE (Poudre School District)

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FACILITY USE REQUEST FORM IN-DISTRICT INDOOR FACILITY USE (Poudre School District)

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Customer Support Center
Poudre School District
2445 LaPorte Avenue
Fort Collins, CO 80521
Phone: (970) 490-3333 | Fax: (970) 490-3110
csc@psdschools.org
Customer Support Center Updated: 9/14/2017
FACILITY USE REQUEST FORM – IN-DISTRICT
INDOOR FACILITY USE
Fill out the following information and submit request to the Customer Support Center. Submission of request does not guarantee
approval; reservation will not be confirmed until the Facility Use Permit and
Acknowledgement of Receipt is received. Please allow
10 business days for processing. See district policy KF – Use of District Facilities,
Facility Use Guidelines (Community), and Personnel Fees for additional details.
Date: _________________________
Requester Name: _________________________________Email Address: __________________________________
Location/Department: ___________________________________Phone: ___________________________________
Event Description: _______________________________________________________________________________
Number Attending: _______________
Equipment and Service Needs:
Chairs ______ AV Equipment/Microphone __________________________________
Quantity Specify Item(s) Requested
Tables ______ Other____________________________________________________
Quantity Please specify
Budget Code_______________________________________________________________________________
Required for applicable personnel (i.e. Custodial) fees only
First Choice of Location
Location: ______________________________________ Space(s) Requested: __________________________
Start Time: ____________End Time: _______________ __________________________
Date (if one day only) ___________________________ __________________________
Complete the following if request is for multiple dates: Other: __________________________
Start Date: ____________End Date: _______________
To Be Held: Weekly Bi-Weekly Monthly Other (List): _______________
Day(s) Held: Sunday Monday Tuesday Wednesday Thursday Friday Saturday
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Customer Support Center
Poudre School District
2445 LaPorte Avenue
Fort Collins, CO 80521
Phone: (970) 490-3333 | Fax: (970) 490-3110
csc@psdschools.org
Customer Support Center Updated: 9/14/2017
Second Choice of Location
Location: ______________________________________ Space(s) Requested: __________________________
Start Time: ____________End Time: _______________ __________________________
Date (if one day only) ___________________________ __________________________
Complete the following if request is for multiple dates: Other: __________________________
Start Date: ____________End Date: _______________
To Be Held: Weekly Bi-Weekly Monthly Other (List): _______________
Day(s) Held: Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Third Choice of Location (if applicable)
Location: ______________________________________ Space(s) Requested: __________________________
Start Time: ____________End Time: _______________ __________________________
Date (if one day only) ___________________________ __________________________
Complete the following if request is for multiple dates: Other: __________________________
Start Date: ____________End Date: _______________
To Be Held: Weekly Bi-Weekly Monthly Other (List): _______________
Day(s) Held: Sunday Monday Tuesday Wednesday Thursday Friday Saturday
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FACILITY USE REQUEST FORM IN-DISTRICT INDOOR FACILITY USE (Poudre School District)

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Completed 14 June 2021

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