Community use of school facilities request form

Community Education Services – Melissa Wright, Director – 816.321.5010

COMMUNITY USE OF SCHOOL FACILITIES

REQUEST FORM
Thank you for your inquiry regarding renting a facility within the North Kansas City School District. Please complete the following information and return this form to me at your earliest convenience.

Building Requested       Facility Requested      

Date(s) Requested       Time(s) Requested      
Contact Name       Organization Name      
Which of the following describes your organization: For Profit       Not for Profit      

*If Not for Profit, please attach 501c3 documentation.

Contact Phone Number       Contact Email      
Contact Mailing Address      
Purpose of Facility Rental      
Approximate Number of Users       Approximate Number of Attendees      
Number of Users Living in the North Kansas City School District      
Comments      
Following approval of this request, North Kansas City Schools will issue a Community Use of School Facility Contract to you. The Community Use of School Facility Contract must be returned with a copy of your Certificate of Insurance ($1,000,000 policy) with NKC Schools named as the policy holder before your event will be confirmed
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NKC School District Use Only
Facility Available Custodian

Food Service Technology

Security Workers

Equipment

Contracted Amount Building Notified

Contract Issued

A Northland Tradition

3100 NE 83^rd St., Suite 2400 Kansas City, MO 64119 816.321.5010 fax [phone]

www.nkcschools.org