Facilities Use Request/Agreement

FACILITIES USE REQUEST

Please note this is a room request only. The Director's office will need to confirm availability of space.

Kodiak College reserves the right to limit access to facilities at the Director's discretion.

You will need to attach:

Certificate of insurance OR go to https://www.ebi-ins.com/tulip UA website to purchase appropriate insurance for your event. (The Kodiak College Facility Code is GNTI 749)
A copy of the Facilities Use Agreement signed by the responsible party.

Description of Event: *

Number of Participants: *

Sponsored by: *

Contact Person: *

Contact Person's Phone: *

Billing/Mailing Address: *

Email Address: *

FAX Number:

Type of Function: *

Student, college staff, or faculty group activity

College sponsored

Non-profit, non-partisan organization *Please provide Tax ID.

Individual, commercial, or private organizations (non-partisan)

Non Profit Organization Tax ID:

Date of Event: *

Start Time of Event: *

Include time needed for set up.

End Time of Event: *

Include time needed for clean up.

Special Needs or Set-Up:

Proof Of Insurance: *

Please attach a copy of your certificate of insurance or go to
https://www.ebi-ins.com/tulip UA website to purchase appropriate insurance for your event. The Kodiak College Facility Code is GNTI 749

(Accepted formats: gif, jpg, png, txt, docx, pdf, doc)

Facilities Use Agreement: *

Accepted file types: gif, jpg, png, pdf