Community Groups Application for Reservation Form Community Groups Application for Reservation Form Name of Requestor * Contact Number of Requestor * Email Address * Name of group AND group point of contact requesting use of the facilities: * Dates and Time Period of Request * Areas and equipment requested: * Auditorium Wireless Mic (1) CD Player LCD Projector DVD Player Handheld Mic Other If other has been selected, please specify and indicate the number required: For what purpose will the facility be used? * Will there be an admission charge? * NoYes If so, how much? (School District policy have different rental agreements for profit and non-profit activities) How many attendees are expected? * Your Electronic Signature * Loyalsock Township School District requires that the parties to certify the application by submitting an electronic signature. The parties agree that the electronic signatures appearing on this agreement are the same as handwritten signatures for the purposes of validity, enforceability and admissibility. If you are human, leave this field blank.
