External Organization - Facility Rental Application

Page 1 of 4

External Organization Facility Rental Application

BEFORE YOU BEGIN - THIS FORM IS NOT SUPPORTED BY INTERNET EXPLORER. PLEASE USE CHROME OR FIREFOX TO APPLY ONLINE. Approval of this request is contingent on the proposed event adhering to the Facilities Use Procedures and Guidelines and Town of Barnstable Public School rules, regulations and policies. Details are located on our website. Submittal of the application is not a guarantee of the room/field or date and time. When scheduling conflicts occur preference will be given to organizations or events directly associated with the Barnstable Public Schools.

	Applications must be submitted at least 2 weeks prior to requested date and a separate application must be submitted for each school requested. Be advised that the applications are processed chronologically by the event date.

	* Asterisked items are required fields.

1.	Today's Date:* This will fill in automatically.
	mm/dd/yyyy

2.	Name of Group/Organization*

3.	Mailing Address of the Organization* Mailing Address, Town, State, Zip

4.	Is this organization declared an 501c3 non-profit?* If "Yes" documentation of non-profit status must be provided prior to permit issuance.
	Is this organization declared an 501c3 non-profit?* If "Yes" documentation of non-profit status must be provided prior to permit issuance.YesNo

5.	Does the organization/group carry liability insurance?* If "Yes", a Certificate of Liability Insurance must be provided prior to permit issuance
	Does the organization/group carry liability insurance?* If "Yes", a Certificate of Liability Insurance must be provided prior to permit issuanceYesNo

6.	Is admission or other fee being charged for this event?* If "Yes", additional approval is required by the Town of Barnstable Licensing Authority prior to permit issuance and copy of approval provided to the School Facilities Department.
	Is admission or other fee being charged for this event?* If "Yes", additional approval is required by the Town of Barnstable Licensing Authority prior to permit issuance and copy of approval provided to the School Facilities Department.YesNo

7.	Is there a donation requested?* If "Yes" please answer #8
	Is there a donation requested?* If "Yes" please answer #8YesNo

What will the donations being requested be used for?

Organization's own purpose

Charitable purpose

Other, please specify

9.	Applicant/Contact Person for the Event:*

10.	Applicant/Contact Phone Number:* Provide the number that you regularly answer

11.	Applicant/Contact Email Address:* Please provide the email address that you check regularly.

12.	Is the Applicant/Contact Person above also responsible for payment of invoice?* If "No" please answer #13
	Is the Applicant/Contact Person above also responsible for payment of invoice?* If "No" please answer #13YesNo

13.	Name of person responsible for payment. Include phone number and e-mail address:

14.	Date(s) Needed for Event:* MM/DD/YYYY If multiple dates, please include all dates. For a recurring schedule, please indicate the day(s) of week and frequency (e.g. Every Tuesday from March 2016 to June 2016)

15.

School Requested*

Barnstable Community Innovation School, Hyannis

Barnstable High School, Hyannis

Barnstable Intermediate School, Hyannis

Barnstable United Elementary School, Marstons Mills

Barnstable West Barnstable Elementary, Barnstable

Centerville Elementary, Centerville

Hyannis Elementary, Hyannis

West Villages Elementary, Hyannis

16.	Name of Room(s) or Field(s) or Room Number(s)* Enter multiple rooms with commas

17.	Start Time:* Include set-up time

18.	End Time:* Include break-down time

19.	What type of event is this? What is the intended use for the space? What is the name of the event?* If a movie is being shown, please include the Title and Rating of the movie.

20.	Number in Group/Anticipated Attendance:* Additional approval signatures are required from the Police and Fire Departments for events with greater than 300 people.

21.	Custodial Assistance:* Do you need assistance with load in, set up and/or break down of your equipment for the event?

22.	If you answered "yes" to question 21 above, please be specific with the assistance you need?*

23.	Is this a public event where food will be served and/or sold? * If "Yes" approval and permit must be obtained from the Town of Barnstable Health Department with a copy provided to the School Facilities Department.
	Is this a public event where food will be served and/or sold? * If "Yes" approval and permit must be obtained from the Town of Barnstable Health Department with a copy provided to the School Facilities Department.YesNo

24.	Is advertising signage for this event being placed anywhere in Barnstable?* If "Yes", the Zoning Department must be contacted to approve the signage and placement and copy of permit provided to the School Facilities Department.
	Is advertising signage for this event being placed anywhere in Barnstable?* If "Yes", the Zoning Department must be contacted to approve the signage and placement and copy of permit provided to the School Facilities Department.YesNo

25.	Supplies and/or Equipment needed (tables, chairs, podium, etc.) Please be specific with number of tables, chairs, etc.

26.	Audio/Video/Computer Items Requested: Enter equipment here such as projector, screen, microphones, laptop, etc.

27.	Special Set-Up Requirements/Comments: Use this space to provide additional information for the event (e.g. 60 chairs in a presentation style or 10 chairs in a circle, etc.) and other details that Custodial or AV Staff need to be notified about.