North Tempe Multi-Generational Facility ROOM RESERVATION REQUEST 2012

1555 N. Bridalwreath St, Tempe AZ www.tempe.gov/northtempe Phone: 480-858-6500 Fax: 480-858-6545

RESPONSIBLE PARTY INFORMATION Last Name First Name Business Phone Cell/Home Phone

ORGANIZATION INFORMATION Organization Name: Mailing Address City St Zip

Business Phone

Fax

Email Address
Will selling or promoting a commercial product or service take place during the meeting/event?

Is the Organization Non-Profit?

Yes

No

Yes

No

MEETING INFORMATION Description of Meeting/Event: Number of Attendees:

Will food/drink or arts & crafts be used? Yes

# of Tables Needed:
No Target Group(s): Children Teens

# of Chairs Needed:
Adults 18+

Any special requests/needs:

ROOM RESERVATION POLICIES

Use of facility for religious services , political purposes or profit-making functions is prohibited.(City Code section 23-57) A Tempe resident must be designated as the Responsible Party, complete this form and MUST be present during the entire meeting/event. All requests must be submitted a minimum of 2 weeks prior to the event. Please allow 1 week for this application to be processed. This application is not final approval of your event, including date and location. You are not authorized to advertise an event in a City of Tempe facility until you have received written confirmation. Your request should include time for setup and take down. The organization is responsible for their own setup, cleanup and returning any furniture to its original position. The organization must check-in at the front desk, pick up an attendance form and return it completed before leaving the facility. Selling or promoting a commercial product, service or anything for personal gain is prohibited. No smoking or alcoholic beverages are permitted in the facility. Any changes or cancellations of reservations must be made ONLY by the responsible party. If a cancellation is necessary, call and notify the facility at least 48 hours prior to the event. Three no-shows could result in termination of scheduled use.

I have read the Room Reservation Policies and will ensure, as the Responsible Party of the meeting/event, which all members in charge will also read and adhere to these policies.

Signature of Responsible Party

FOR OFFICE USE ONLY DATE RECEIVED:

Date
RESERVATION #:

BEGIN RESERVATION REQUESTS December 1, 2011 February 6, 2012

TIME PERIOD January, Feburary, March 2012 April, May, June 2012

HOURS AVAILABLE Monday-Thursday 8am-8:30pm Fridays 8am-7:30pm Saturdays 10am-4:30pm Sundays CLOSED

ROOM PREFERENCE: MANZANITA (25) MESQUITE (25) PALO VERDE (25) SISSO (25) CONFERENCE (10) JOSHUA (40) JUNIPER (40)

DATES REQUESTED (PLEASE CIRCLE) JANUARY 2012

S 1 8 15 22 29 M 2 9 16 23 30 T 3 10 17 24 31 W 4 11 18 25 TH 5 12 19 26 F 6 13 20 27 SA 7 14 21 28 S 5 12 19 26 M 6 13 20 27

FEBRUARY 2012
T 7 14 21 28 W 1 8 15 22 29 TH 2 9 16 23 F 3 10 17 24 SA 4 11 18 25 S 4 11 18 25 M 5 12 19 26

MARCH 2012
T 6 13 20 27 W 7 14 21 28 TH 1 8 15 22 29 F 2 9 16 23 30 SA 3 10 17 24 31

Facility Closed: January 2nd & 16th

Facility Closed: February 20th

Spring Break: March 12th-16th Facility Closed: March 31st HOURS:

HOURS:

HOURS:

APRIL 2012
S 1 8 15 22 29 M 2 9 16 23 30 T 3 10 17 24 W 4 11 18 25 TH 5 12 19 26 F 6 13 20 27 SA 7 14 21 28 S 6 13 20 27 M 7 14 21 28

MAY 2012
T 1 8 15 22 29 W 2 9 16 23 30 TH 3 10 17 24 31 F 4 11 18 25 SA 5 12 19 26 S 3 10 17 24 M 4 11 18 25

JUNE 2012
T 5 12 19 26 W 6 13 20 27 TH 7 14 21 28 F 1 8 15 22 29 SA 2 9 16 23 30

Facility Closed: May 28th HOURS: HOURS: HOURS:

JULY 2012
S 1 8 15 22 29 M 2 9 16 23 30 T 3 10 17 24 31 W 4 11 18 25 TH 5 12 19 26 F 6 13 20 27 SA 7 14 21 28 S 5 12 19 26 M 6 13 20 27

AUGUST 2012
T 7 14 21 28 W 1 8 15 22 29 TH 2 9 16 23 30 F 3 10 17 24 31 SA 4 11 18 25 S 2 9 16 23 30

SEPTEMBER 2012
M 3 10 17 24 T 4 11 18 25 W 5 12 19 26 TH 6 13 20 27 F 7 14 21 28 SA 1 8 15 22 29

Facility Closed: July 4th HOURS: HOURS: HOURS:

Facility Closed: September 3rd

OCTOBER 2012
S 7 14 21 28 M 1 8 15 22 29 T 2 9 16 23 30 W 3 10 17 24 31 TH 4 11 18 25 F 5 12 19 26 SA 6 13 20 27 S 4 11 18 25

NOVEMBER 2012
M 5 12 19 26 T 6 13 20 27 W 7 14 21 28 TH 1 8 15 22 29 F 2 9 16 23 30 SA 3 10 17 24 S 2 9 16 23 30

DECEMBER 2012
M 3 10 17 24 31 T 4 11 18 25 W 5 12 19 26 TH 6 13 20 27 F 7 14 21 28 SA 1 8 15 22 29

Fall Break: October 8th - 12th

Facility Closed: November 12th, 22nd & 23rd

Facility Closed: December 25th Facility Open 7:30am-5pm December 24th & 31st HOURS:

HOURS:

HOURS: