Facilities Use Request - FUR - 4-H - PLACER

Facilities Use Request Form for 4-H CLUB and PROJECT MEETINGS

4-H Club Leaders and Project Leaders –
Before you start any Club meetings, project meetings or events,
YOU MUST SUBMIT a FACILITY USE REQUEST Form (FUR) to the 4-H office or 4-H CES.

If planning an event, please use the Facilities Use Request: Countywide Events

PLEASE NOTE: Incomplete request will create delay in processing your request in a timely manner. use the checklist below to insure you have all the needed information.

CHECKLIST:

Name/contact info of person requesting the facility - (4-H club leader/project leader)
Facility/Location available for dates needed - (contact facility, verify, and confirm dates)
Additional forms required by facility - (contact facility to ask and obtain forms, if any)
Facility physical address – (where meetings will take place)
Facility contact name, email & phone - (not the same as person requesting)
Dates and times needed for meetings – (Include set-up and clean-up times)

Any questions, contact us at placer4h@ucanr.edu or call us at 530-889-7386

Facilities Use Request - FUR - 4-H - PLACER - Club or Project MEETINGS

Facilities Use Request Form for 4-H CLUB and PROJECT MEETINGS

4-H Club Leaders and Project Leaders –
Before you start any Club meetings, project meetings or events,
YOU MUST SUBMIT a FACILITY USE REQUEST Form (FUR) to the 4-H office or 4-H CES.

Please allow a MINIMUM of 10-14 days for the processing of any additional dates and times for existing insurance agreements.

NEW AGREEMENTS may take longer.

FACILITY INFORMATION

Are meetings held at a 4-H Volunteer, someone else home or property, or other location?

FILL OUT this portion if HOMEOWNER LOCATION is being used

FILL OUT this portion if LOCATION IS OTHER LOCATIONS (not Private Property)

Does the facility have a contract or application to fill out:
(Please request form(s) from facility and submit with FUR)

MEETING INFORMATION

DATE(s) REQUESTED

Please enter below ALL the DATES needed for EACH MONTH

* If a month has NO Meetings - Please enter "0" or N/A
* If your meetings are more than one meeting a month, separate each date by a comma.
(example: 02/12, 02/20, 02/30)

SELECT DAY(S)

ENTER Meeting/Project START TIME (include time for set-up):

ENTER Meeting/Project END TIME (include time for clean-up):

YEAR:

YEAR:

Facilities Use Request - FUR - 4-H - PLACER - Club or Project MEETINGS

Facilities Use Request Form for 4-H CLUB and PROJECT MEETINGS

4-H Club Leaders and Project Leaders – Before you start any Club meetings, project meetings or events, YOU MUST SUBMIT a FACILITY USE REQUEST Form (FUR) to the 4-H office or 4-H CES.

Please allow a MINIMUM of 10-14 days for the processing of any additional dates and times for existing insurance agreements.

**NEW AGREEMENTS may take longer.**

FACILITY INFORMATION

Are meetings held at a 4-H Volunteer, someone else home or property, or other location?

FILL OUT this portion if HOMEOWNER LOCATION is being used

FILL OUT this portion if LOCATION IS OTHER LOCATIONS (not Private Property)

Does the facility have a contract or application to fill out: (Please request form(s) from facility and submit with FUR)

MEETING INFORMATION

DATE(s) REQUESTED

Please enter below ALL the DATES needed for EACH MONTH

* If a month has NO Meetings - Please enter "0" or N/A* If your meetings are more than one meeting a month, separate each date by a comma.(example: 02/12, 02/20, 02/30)

SELECT DAY(S)

ENTER Meeting/Project START TIME (include time for set-up):

ENTER Meeting/Project END TIME (include time for clean-up):

YEAR:

YEAR:

4-H Club Leaders and Project Leaders –
Before you start any Club meetings, project meetings or events,
YOU MUST SUBMIT a FACILITY USE REQUEST Form (FUR) to the 4-H office or 4-H CES.

NEW AGREEMENTS may take longer.

Does the facility have a contract or application to fill out:
(Please request form(s) from facility and submit with FUR)

* If a month has NO Meetings - Please enter "0" or N/A
* If your meetings are more than one meeting a month, separate each date by a comma.
(example: 02/12, 02/20, 02/30)