Name of Facility: Address:
Location/Driving Directions
Contact Person Name, Title & Phone #:
Facility Phone #:
Description of Facility:
Meeting room(s): # Occupants ___, tables # ___, chairs # ___, audio visual equipment = white board ___, screen ___, slide projector ___, TV – VHS ___, TV – DVD ___, other ________________, microphone ___
Kitchen – stainless steel equipment ___, MDH inspected & approved ___, stove ___, oven ___, microwave ___, dishwasher ___, refrigerator ___, utensils ___, cookware ____, dishware _____, serving dishes ___, coffee pot ___
Dining Room – size ___, tables #___, chairs # ___, audio visual (white board, screen, slide projector, TV – VHS, TV – DVD, other ____________________, microphone _____
Gymnasium – size (full court or half court) _____, bleachers ____, chairs ___, equipment (basketball hoops, balls, volley ball poles & nets, padded mats, etc. _________,Dressing room ___, showers ___
Auditorium/theatre – stage size ___, dressing room (s) # ___, seats or chairs # ___, sound system ___, lights ___, rigging ___, Microphone ___, stands ___
Other – swimming pool ___, ice rink ___, fields for various sports _______________, tennis courts ___, bike/hike trails _________, playground ___, park ___, pavilion ___, picnic tables ___, skateboarding ___, fishing dock/pier ___, public access to lake ___, boat launch/ramp ___, beach ___, lifeguard ___, outdoor bathrooms ___, office, additional features or comments __________________________________________
Days of Operation:
Hours:
Fees (Profit Rate & Non- Profit Rate) Hourly $____, daily $ ___, trash removal $___, cleaning $ ___, other - ______$___
Current Uses/Users:
Preference Given to: |