□□
Request to Waive or Reduce Facilities Use Fees
This form is required to request waived fees related to use of RCC facilities (facility fees, staff fees and parking fees). Organizations requesting a waiver must
submit this request no later than 4 weeks prior to event date.
Date of request:
Tax ID Number:
Organization or RCC/RCCD Department Name:
Contact name: Phone:
Email: Organization website:
Event name (will be used to publicize event):
Date(s): Time (s)
Will there be any fees charged for the event? If yes, list the fees.
How long has your organization been serving the RCC community?
Does your organization have any representatives affiliated with RCCD? No Yes If yes, state who and what the
affiliation is (i.e. Employee, foundation member)
What is the goal of your event?
How does this align with RCC’s Mission or what benefit is being provided to the community?
(Please add attachment if additional space is needed.
Updated January 2020
FOR
OFFICIAL USE
ONLY
TOTAL ESTIMATED COSTS
$
EVENT REFERENCE:
□ Waive facility fees
□ Waive staff fees
□ Waive parking fees
estimated fees $
estimated fees $
estimated fees $
reduce by $/%
reduce by $/%
reduce by $/%
Reduction app
oved in the amount of $/% □ Request denied. Does not ali
n with RCC’s mission
Event Histo
y:
VP, Business Si
natu
e
reduced fees o
denied
Date
President Si
natu
e
par
in
and/o
full waive
only
Date
Comments:
Date Received
