Application for Use of School Facilities

Please complete the form below. Required fields marked with an asterisk *

Applicant/User Information - The following will be used for billing.

Date of Request*

Answer required for "Date of Request"

Name of Organization*

Answer required for "Name of Organization"

Address

Street Address*

Answer required for "Street Address"

City*

Answer required for "City"

Zip/Postal*

Answer required for "Zip/Postal"

Contact Person*

Answer required for "Contact Person"

Phone*

Number Required

Email*

Answer required for "Email"

Description of Use/Activity/Event

Type of Activity*

Answer required for "Type of Activity"

Expected Attendance #*

Answer required for "Expected Attendance #"

Date Desired (If more than one day, indicate below.*

Answer required for "Date Desired (If more than one day, indicate below."

List here if more than one day or a range of dates.*

Ex: "Jan 5-8"

Answer required for "List here if more than one day or a range of dates."

Activity Start Time*

Answer required for "Activity Start Time"

Activity End Time*

Answer required for "Activity End Time"

Admission Charge (If Any): Adult, Student, Child, otherwise, "NONE"*

Answer required for "Admission Charge (If Any): Adult, Student, Child, otherwise, \"NONE\""

Facilities Desired*

Answer required for "Facilities Desired"

Auditorium

Cafeteria/Commons

H.S. Gym

Elementary Gym

H.S. Classroom (indicate classroom # below)

Elementary Classroom (indicate classroom # below)

H.S. LLC (Library)

Elementary Library

Other:

If you desire a specific classroom(s) please list here:

Answer required for "If you desire a specific classroom(s) please list here:"

Special Equipment Request (if any)*

Answer required for "Special Equipment Request (if any)"

Microphone

Projector/Screen

Audio for Presentation

Other:

Type of Computer Video Connection for Presentation (if needed, otherwise, select "NONE")*

Answer required for "Type of Computer Video Connection for Presentation (if needed, otherwise, select \"NONE\")"

HDMI

Airplay

NONE

Other:

Food Service Requested*

Answer required for "Food Service Requested"

Yes (Please fill out food order form)

Hurley School District: Use of School Facilities Fee Schedule

The following fee schedule shall be used when applicable. The business office shall be responsible for billing for usage.

HIGH SCHOOL	All Day	Morning	Afternoon	Evening
Auditorium	125.00	60.00	60.00	60.00
Commons	125.00	60.00	60.00	60.00
Gymnasium	125.00	60.00	60.00	60.00
Cafeteria	75.00	30.00	30.00	30.00
Classrooms	30.00	15.00	15.00	15.00

ELEMENTARY	All Day	Morning	Afternoon	Evening
Gymnasium	60.00	30.00	30.00	30.00
Classrooms	30.00	15.00	15.00	15.00

Please fix the highlighted areas below before submitting.

Application for Use of School Facilities