Please fill out the following form with your contact information and details of the Room/Space you would like to request.
Applicant Name
Name Required.
Phone Number
Phone Number Required.
Email Address
Email Address Required.
Must Be Valid Email.
start time
Start Time Required.
end time
End Time Required.
Select School
Select-School
Central_Office
Durand_Eastman
Eastridge_High_School
Helendale_Road_Primary_School
Ivan_Green
Laurelton-Pardee_Intermediate_School
Middle_School
Select a Room
Please select an item.
Activity to be conducted
Activity Description is Required.
Activity for Fundraising or for Profit Use
Name of Group/club running Activity
A value is required.
Number of People Attending
Approximate Head Count is Required.
Other Services
- IT Support/Equipment
Yes
No
Please make a selection.
Please Describe
- Security Support
Yes
No
Please make a selection.
Please Describe
- Additional Furniture (tables, chairs, desks)
Yes
No
Please make a selection.
Please Describe
- Use of Parking Lot
Yes
No
Please make a selection.
Please Describe
- Use of Locker Rooms
Yes
No
Please make a selection.
Please Describe
