Facilities Request

Facilities Request

University Academy Use of Facilities Request

Enter phone numbers in xxx-xxx-xxxx format. Facilities requests must be submitted at least 7 days in advance.

Name of Individual/Organization: 

Name of Contact:  Contact Phone: 

Email Address of Contact: 

UA Affiliation:  If Other: 

Date(s) of Event: Time: Setup from:  to:
NOTE: Requests submitted within 48 hours of event will not be approved. Event from:  to:
Description: Cleanup from:  to:
Number of Attendees Expected: NOTE: Add AM/PM to at least one of the time fields.

Please provide Room Setup and other notes:

Examples of room setup: Classroom, Horse Shoe, Testing, Audience, Hearing, Dining, Open Title I, Open Chairs Around Perimeter, Enrollment, Mock Trial, Healthy Kids w/ Divider.

Hold down Ctrl to select multiple options in the menus below.

Desired LocationAudiovisual Equipment Needed

If Other: 

Food Service Required? 

If yes, please indicate menu items: 

NOTE: Cleaning staff will not be responsible for taking down decorations or discarding remaining food, etc.  Any items left will be discarded.

Security Required? 

NOTE: An additional mandatory minimum $50 per hour fee is required for all events scheduled after 6:00pm and on Saturdays as well as a $50 per hour mandatory minimum fee for custodial service for all Saturday events. An energy surcharge may apply.

UA Employees: select your direct supervisor below. All other users: please select Becky Johnston.

If you are employed at UA and you report to Tony Kline, please select Becky Johnston from the Supervisor list below so she can review availability for your request.

Approval Supervisor:

Security Measure
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