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Jefferson Community College
1220 Coffeen Street
Watertown, NY 13601
Samuel Guthrie Building Room 2‐012
315‐786‐2405
Facilities Use Onl
Banner ID #:
Please read the attached guidelines before signing. Fill in all information and return the completed form to the Facilities Secretary at
least 45 days prior to the scheduled event. All events are subject to cancellation by JCC Administration. Please print clearly and
complete all boxes for proper processing.
Today’s Date: Department/Division : Contact Person:
Contact Phone: ( ) ‐ Contact Email: Event Name:
Purpose of Event: Other Sponsoring Organization: Estimated Number of Attendees:
Are any participants under the age of 17?
Yes
No
Schedule of Events
Please be specific on actual arrival times, performance times, set‐up times, AM or PM
Date Day Applicant Set‐Up Time Actual Event Hours Applicant Tear‐Down Hours
to to
to
to to to
to to to
to to to
to to to
to to to
Will there be an admission charge for this event? Yes No If yes, how much?
Facilities Requested
Amphitheater
Specify: 6‐002
(cap. 120)
2‐107 (cap. 150)
Computer Lab (# 25) Student Lounge
CLC Fireside Lounge
Parking Lot(s)
Specify:
Walker Instructional
Dining Room
Athletic Field
Specify:
East Hall Hub
Commons
McVean Center Gymnasium
Gymnasium Foyer
Hall of Fame Lobby
Classrooms
How many:
Distance Learning Rooms
Specify: E-120
(cap. 20)
Grounds
Sturtz Theater
(cap. 500)
Sturtz Theater Lobby
Notes:
