Facility Use

Office # _____________ Amount Paid _____________ Today's Date _____________________

Non refundable application fee: $10.00

1. Name of organization________________________________________________________

2. Address of organization_______________________________________________________

3. Person Responsible__________________________________________________________

4. Contact Phone #(s)__________________________________________________________

5. Address of Responsible Person_________________________________________________

6. Day(s) of the week (circle): M T W TH F SA SU
   List all dates___________________________________________________________

7. Entrance time____Activity start______Activity end________Admission___________

8. Description of activity________________________________________________________

9. Circle building requested WING HIGH SCHOOL FORESTDALE OAK RIDGE

10. Facility requested ___Gymnasium ___Cafeteria ___Multi-purpose ___ Library
    ___Classroom ___Other (describe) ___________________________________________

11. Equipment needed ___PA System ______# chairs ______# tables ___Other (describe below)
    _________________________________________________________________________

12. You will be required to have the following - For all school groups, principal please check all that apply:
    _____ Rental fees (from time of entrance) _____ Monitor @ $15.00 per hour
    _____ Custodian as per CBA agreement ($27 per hour as of 6/6, 3hr minimum)

    _____ Tech @ $28.00 per hour

    _____Kitchen worker at $20.00 per hour (3hr minimum). Please call 508-888-4900 ext. 5014 to schedule.
    ___ Police detail - You are responsible for calling the Sandwich Police Department (508 888 3343) to schedule. Fee paid directly to Sandwich Police Department.
    ___ Fire detail required on groups of 100+. Form submitted directly to the Sandwich FD 30 days in advance (indoors and outdoors). Failure to comply will result in denial of application.
    ___ Submit a liability insurance certificate naming the TOWN OF SANDWICH as additional insurers. Coverage must include $1,000,000/$3,000,000 for bodily injury and for property damage.
    Facilities Use special instructions: