Fillable Form 1.: For Caada College Internal & ASCC (Canada College)

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Form 1.: For Caada College Internal & ASCC (Canada College)

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The Form 1.: For Caada College Internal & ASCC (Canada College) form is 3 pages long and contains:

  • 5 signatures
  • 27 check-boxes
  • 90 other fields

Country of origin: US
File type: PDF

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For Cañada College Internal & ASCC Events ONLY
San Mateo County Community College District
Request for Use of Facilities
Cañada College
4200 Farm Hill Blvd.
Redwood City, CA 94061
(650) 306-3100
College of San Mateo
1700 West Hillsdale Blvd.
San Mateo, CA 94402
(650) 574-6161
Skyline College
3300 College Dr.
San Bruno, CA 94066
(650) 738-4100
Yes
Applicant Information
Application Date:
Is this an ASCC/Club event?
Name of Club/Department:
Club Advisor/Event Contact:
Cell Phone:
Email:
Club Advisor 'G' Number:
Day of Event Contact:
Office Phone:
Cell Phone:
Email:
Facility Use/ Event Information
Name of Event:
Arrival Time:
Event Start Time:
Event End Time:
Departure Time:
Total Hours:
Facility/ Room to Rent:
Additional Facility/ Room to Rent:
Estimated Attendance :
Adults (over 18)
Minors (under 18)
Total
Spectators (if sports event):
Total Attendance :
Page 1 of 3
Update 6/1/2017
District Office
3401 CSM Dr.
San Mateo, CA 94402
(650) 574-6550
Additional Facility/ Room to Rent:
1.
2.
3.
4.
5.
6.
Office Phone:
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
Reservation #
No
Type of Event:
Select One:
14a.
Event Date(s):
Description of Event Activities:
14b.
Reset Form
Select One :
Select One :
Select One :
0
0
0
0
0
For Cañada College Internal & ASCC Events ONLY
San Mateo County Community College District
Request for Use of Facilities
Check the box if you are:
Collecting admission or sales – For what purpose are the funds used? Have you completed a fundraiser approval form?
Serving food – Please describe:
Selling concessions – Please describe:
Having live music
Having minors in attendance
Multi-day event
Media Equipment - Check the box and enter amount required.
Projector
Projection screen
Other
D
VD player
MP3 connector
S
ound
s
ystem
Mi
crophone
Furniture – Check the box and enter amount required.
6 foot table
8 foot table
Chair
Podium/ Lectern
Stage
Round table
Other:
Special Arrangements / Attach diagram for event layout details:
Page 2 of 3
Updated 6/1/2017
Canopy
Trash Can
a.
b.
c.
d.
23.
e.
f.
24.
a.
b.
c.
d.
e.
f.
g.
25.
a.
b.
c.
d.
e.
f.
g.
h.
i.
26.
portable
cordless
Reservation #
For Cañada College Internal & ASCC Events ONLY
San Mateo County Community College District
Request for Use of Facilities
Page 3 of 3
1.
2.
3.
Facilities Assigned:
1.
2.
3.
4.
5.
Personnel Requirement (All staff charges will be at a two hour minimum):
Type # of
Staff
Estimated
Fees
Type # of
Staff
Estimated
Fees
Type # of
Staff
Estimated
Fees
Security Technician Grounds
Custodial Special Tech. Other:
Total Estimated Fees:
Application Facilities Rental Personnel
Equipment Other Total Est. Fees
Vice President of Administrative Services:
Date:
(Signature required when using Special Events Funds and/or when additional insurance is neccessary.)
Updated 6/1/2017
31.
36.
32.
34.
35.
Date:
Date:
Club Advisor/Event Contact:
27.
28.
The applicant understands and agrees this application is not a confirmation of facility use and that the date(s) for the event will not be
confirmed until the application has been reviewed and approved by College.
Upon approval by College, the applicant will be required to
sign the District’s Facilities Use Agreement to finalize the application. This application is not valid unless a Facilities Use Agreement, signed
by both the Permittee and the District, is attached. Total estimated fees are based on information provided by the applicant. Applicant is
responsible for actual fees incurred. Any additional fees will be invoiced and will be due upon receipt.
Reservation #
FOAP:
Account Number (FOAP):
Apply College Events Fund:
--------------------------- The Facilities Rental Office will complete the sections below. -------------------------
31a.
Insurance:
33.
This event includes persons attending who are not
directly affiliated with the College and/or the level of
risk associatated with planned activities are beyond
the District's standard coverage. Additional
insurance may be required.
No
Yes
The College Supervisor or Vice President of Student Services should complete the Account Number to be applied to this event.
College Supervisor:
29.
Student Life & Leadership Manager:
(applicable if student club event)
30.
Vice President of Student Services:
(applicable if student club event)
Date:
Date:
$ 0.00
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Form 1.: For Caada College Internal & ASCC (Canada College)

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Completed 2 February 2021

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