Activity Request Form

Please complete the form below. Required fields marked with an asterisk *

Title of Activity*

Answer Required

Description of Activity*

Answer Required

Date of Activity*

Answer Required

Time of Activity*

Answer Required

How many hours?*

Answer Required

Number of Participants*

Answer Required

Club/Organization*

Answer Required

Faculty Sponsor*

Answer Required

Room Number*

Answer Required

Email*

Answer Required

Equipment Needed

Answer Required

Tables

Chairs

Sound system

Projector

Other:

How many of the above items are requested?

Answer Required

Custodial Services Needed

Answer Required

Restroom access

Other:

Financial Services Needed

Answer Required

Cash box

Tickets

Purchase Order

Other:

Campus Aides Needed

How many?

Answer Required

Location Requested

Answer Required

Small Gym

Football Field

Senior Quad

Big Gym

PLEASE NOTE: You must still go here to reserve the location. If you do not reserve the location via that link you it will not be guaranteed.

Faculty Chaperones

Answer Required

Will activity be held between 6PM to 6AM?

If yes, Beyond The Bell must be contacted regarding a civic center permit (after school/weekends/unassigned days a permit is REQUIRED).

Civic Center Permit Office: (213) 241-6900 or www.btb.lausd.net

Please fix the highlighted areas below before submitting.

Activity Request Form