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:
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signature
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signature
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signature
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signature
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signature
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