Sample Building Use Form
Related MediaSample Building Use Form
For Non-_________________Use
Name: ____________________________ Phone: (H) _______________(W) _______________
Address: _______________________________________________________________________
Date Needed: __________________ Time: From _________________ to ________________
Reason for Building Use: _______________________________________________________
Number of People Expected: ____________________________________________________
Information below will be determined by the Building Superintendent who will contact inquirer.
Previously established Non-________ Wedding Fees are shown on the _________ Wedding Policies.
Mandatory Fees:
Deposit/Application Fee: |
$50.00** |
Janitorial Fee ($17/hour) |
_______ |
_____________ Representative ($17/hour) |
_______ |
Utility Fee ($6/hour) |
_______ |
Sub-Total: |
_______ |
Optional Fees:
Audio/Visual Assistant ($17/hour) (Auditorium Only) |
|
Sub-Total |
_______ |
Mandatory Fees |
_______ |
Optional Fees |
_______ |
TOTAL FEES |
_______ |
**Due after approval and prior to use; balance due within five working days of date building used. Fees will be adjusted according to actual fees and times. Deposit refundable if no damage occurs.
Fees for Non-__________ May be Waived for the Following Reasons:
1. By Elder approval
2. If the activity meets approved ____________ usage guidelines and can be scheduled during times of normal ___________building use when space is available.
Applicant's Signature: ________________________________________ Date: ___________
Elder Approval/Disapproval: ___________________________________ Date: ___________
Related Topics: Administrative and Organization