Glenbard Township High School District 87
Policy 8:20-E2
GLENBARD TOWNSHIP HIGH SCHOOLS
FACILITY USE CONFIRMATION
(Circle) East North South West
Date___________________
User __________________________________________________________Phone____________________
User’s Address_____________________________________________________________________________
User’s Chief Administration Officer______________________________________________________________
A. General Information:
1. Nature and Purpose of Use:_____________________________________________________________
2. Estimated Attendance:_________________________________________________________________
3. Dates & Times of Facility Use:___________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
4. User’s Supervisor During Activity:________________________________ Phone___________________
5. Building Representative to Contact:______________________________Phone____________________
B. Facility Reserved:_____________________________________________________________________
C. Equipment Reserved:__________________________________________________________________
D. Other Requests:______________________________________________________________________
______________________________________________________________________
E. Billing Information: Name______________________________________Phone____________________
Address:______________________________________________________________________________
F. Charges:
1. Facility Rental:________________________________________________ __________________
2. Certified Personnel:____________________________________________ __________________
3. Custodial Personnel:___________________________________________ __________________
4. Other Personnel:______________________________________________ __________________
5. Other Costs (specify):__________________________________________ __________________
Total: $_________________
G. Certificate of Liability & Indemnity Insurance Required (See Exhibit A-#1.):________________________
Date Received:______________________________________________________________________
By:_____________________________________ By:________________________________________
Authorized Representative for District 87 Authorized Representative for the User
Title:____________________________________ Title:______________________________________
Payment for building use must be received by the District Office at least 15 days prior to the
date of use. Additional expenses that exceed the amount prepaid will be calculated on the
actual usage and billed separately.
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