REQUEST FOR USE OF SCHOOL FACILITIES

PORTA COMMUNITY UNIT SCHOOL DISTRICT #202

P.O. BOX 202, 17651 BLUEJAY ROAD, PETERSBURG, IL 62675

*** THIS FORM IS NOT USED FOR POOL RENTALS ***

Pool: $150 for first 2 hours, $75 per additional hour (includes one lifeguard & supervisor or manager, may require additional lifeguards at $15 per hour paid by the renter). Pool reservations can be made by contacting Rachel Frost at rfrost@porta202.org or 217-632-4745, Ext. 7.

APPLICANT DETAILS

Applicant Full Name *

Organization, if applicable

if a Community Organization is involved, please indicate that here

Applicant Phone Number *

Applicant Email *

Applicant Street Address *

City *

State *

Country

Postal Code *

EVENT TYPE / DATE / TIME

When providing your start and end times, be sure to include any time you need for set-up and clean-up.

For example:
Event is 5-7 pm. You want to access two hours early to prepare. You think it will take an hour to clean up afterward and be completely out of the space.

You should list your start time as 3 pm and your end time as 8 pm. Total time needed = 5 hours.

What is this event? Please describe how you will be using the space. *

Event Date *

Start Time *

End Time *

Total Hours *

Estimated Attendees *

SPACE & EQUIPMENT REQUIRED

Building *

Area Needed *

If Other, please explain

School Equipment Needed

If Other, please explain

Custodian Required *

STAFF INVOLVEMENT

ALL EVENTS are required to have at least one PORTA Staff member in attendance. The hourly rate for the staff member in attendance will be charged at $35 per hour. Please list the staff member who will be supervising the event. If you do not have a designated staff member selected and would like to request a staff member, please check the Staff Member Request box below. All approvals of facility requests will be subject to finding a staff member willing to attend the event.

Do you have a PORTA Staff Member participating? *

Name of Staff Member Attending

Staff Compensation Waived

Yes - staff agreed to waive compensation fee

No - staff has not agreed to waive compensation fee

Applicant Signature

Clear

*** IMPORTANT: READ BEFORE YOU SUBMIT***

When you click the submit button below, your request will be routed for appropriate approvals. Please note that each request requires review and approval by several team members. You will receive an immediate confirmation via email that we have received your request, but your request is NOT APPROVED until all of the necessary reviews have occurred. You will be notified when this process is complete.