FRANKLIN AREA SCHOOL DISTRICT APPLICATION FOR PERMISSION TO USE SCHOOL FACILITIES I, representing _______________________________________, hereby apply for Name of Organization

permission to rent the following facilities: School:_____________________________________________________________________ Room (s):___________________________________________________________________ Date (s):_______________________________ Time:________________________________ Event:______________________________________________________________________

I also request the use of: A/V Equipment:______________________________________________________ Kitchen Facilities:_____________________________________________________ Other:______________________________________________________________

Will admission be charged to this activity, or will a collection be taken, or will contributions be solicited? Yes _____ No_____ If yes, the amount of admission: Adults:__________ Children:__________ Will the activity or meeting be open to the public?

Yes_____

No_____

Certification: I certify that I have read and will abide by the attached rules and regulations of the Franklin Area School District. Organization Name:___________________________________________________ Contact Person:_______________________________________________________ Address:____________________________________________________________ ____________________________________________________________ Telephone:_______________________________ ___________________________________ Signature ___________________________________ Date of Request

Office Use Only: Building Principal:________________________________________________________________ Date Approved_________________ Date Denied_____________________ Business Manager:________________________________________________________________ Date Approved_________________ Date Denied_____________________ Date of Rental Agreement:___________________________ Rental Application 3/27/2015

The mission of the Franklin Area School District, in partnership with families and the community, is to create life-long learners who become responsible members of society. Franklin Area School District is an equal opportunity education institution and does not discriminate on the basis of race, color, creed, disability, national or ethnic origin, sex, or age in its activities, programs, or employment practices as required by Title VI, Title IX, and Section 504. For information regarding civil rights or grievance procedures, contact the Title IX Coordinator or the Section 504 Coordinator at 702 Liberty Street, Franklin, PA 16323 (814) 432-8917.