Request Form for Use of School Facilities

GROUP / ORGANIZATION: __________________________________________________________

ADDRESS: _______________________________________________________________________                                                 

CONTACT PERSON:  ______________________________________________________________

 TELEPHONE:  __________________________                        FAX: ___________________________

E-MAIL ADDRESS:  ________________________________________________________________

FACILITY REQUESTED: ____________________________________________________________             

EVENT: __________________________________________________________________________

DATE OF EVENT:  ______________________         TIME: __________________________________

ALTERNATE DATES: _______________________________________________________________

EQUIPMENT REQUESTED:  __________________________________________________________

_________________________________________________________________________________               

SPECIAL REQUESTS:  ______________________________________________________________

PROOF OF LIABILITY INSURANCE IS ATTACHED.  _____ yes     ______ no

THIS ORGANIZATION HAS RECEIVED A COPY OF THE WISD PROCEDURES FOR USE OF SCHOOL

FACILITIES AND A COPY OF BOARD POLICY REGARDING NON SCHOOL USE OF FACILITIES.  

 ____ yes                 _____ no

REQUEST SUBMITTED BY:  __________________________________________________________

TITLE IN THE ORGANIZATION:  ______________________________________________________

OTHER OFFICERS OF THIS ORGANIZATION:  ___________________________________________

DATE SUBMITTED:  _________________________________________________________________

(Please mail form to 204 W. Rogers Willis, Texas 77378 or fax to 936-890-1404.  Please
attach any additional pertinent information to enable us to timely expedite your request.)