Requested. A unit member may request and arrange with the Superintendent a personal leave without pay.
Requested. Are you fully certified for the new subject/grade area? Yes No Not Certain Reason for Request (s): (The back of this sheet may also be used.) Approved Not approved Principal Signature: Date: Superintendent Signature: Date:
Requested. □8:00am-12:30pm □12:30pm-5:00pm □5:00pm-9:30pm Room(s) Requested: □Sanctuary □Fellowship Area □Café & Kitchen □Fireside Area □Gallery □Adult Classrooms □Children’s Classrooms □Youth Classrooms □Pavilion / Parking Lot Anticipated Number of Participants Will a participant fee be charged? □Yes □No Will food or drink be consumed? □Yes □No Special Needs or Requests: 🞎 Pavilion use requires moving tables and chairs to the pavilion also requires cleaning and returning to their proper locations. □Custodial Cleanup ($50 per time segment) □Sanctuary Sound and or video System ($50 each per time segment) □Attachment to Sanctuary Sound System □Portable Sound System □TV’s or Projection Screens □Musical Instruments – specify Room Use Agreement Approval – Grace Baptist Church: □Approved event added to church calendar □Ministry Coordinator(s) notified of room(s) requested □Other – specify Trustee Signature Printed Name Date Worship Director Signature Printed Name Date Gallery Approval Signature Printed Name Date Release and Indemnity Agreement This agreement is between the above–named organization (“Organization”) and Grace Baptist Church.
Requested. A leave of absence which, at the time it is applied for and granted, is to be used in connection with a known or projected period of temporary disability (i.e. medical or physical inability to perform the employee's job) on the part of the employee. For example, a medical leave may be sought by an employee who is or will be temporarily unable to perform his job by reason of a disabling illness and/or injury, surgery, pregnancy and/or childbirth.
Requested. Day(s) of the Week: Event Hours: From: To: Time requesting access: From: To: Public or Private: If Public, Ticketed or Free: Event Sponsor: Description of Event: *Alcohol Served: Yes No *Alcohol Use Agreement Required Approximate Attendance: Vendor(s): How many: Check All that Apply: Live Music/Dancing: Hours from to *Gambling: Hours from to Demonstrations: Hours from to **Amusement Rides etc.: Hours from to ***Liquor Sales : Hours from to ***Liquor Service: Hours from to ****Food Service: Hours from to ***Liquor Liability Insurance is required when selling/serving * State Gambling License Required **Dept. of Labor & Industries License Required ***State Liquor Control Board License/Permit Required FACILITY & RATE INFORMATION (Pioneer Pavilion Community Center) Please remember you also have a $500 Security Deposit less Cleaning costs in addition to these fees Community Event: Mark which applies Monday - Thursday: 4 hours or less $ 150.00 Monday - Thursday: All-day Event $ 500.00 Fri., Sat. & Sun 4 hours or less $ 250.00 Fri., Sat. & Sun All-day Event $ 600.00 Private Event: Monday-Thursday 4 hours or less $ 300.00 Monday-Thursday All-day Event $ 800.00 Fri., Sat. & Sun. 4 hours or less $ 400.00 Fri., Sat. & Sun. All-day Event $ 900.00 **Nonprofit Organization Event: *Non-profit as defined by the IRS and event must be in Org. name Monday - Thursday 4 hours or less $ 75.00 Monday - Thursday All-day Event $ 250.00 Fri., Sat. & Sun. 4 hours or less $ 125.00 Fri., Sat. & Sun. All-day Event $ 300.00 Early set-up/ Decoration Cost: One - three hours (per hour): X $ 50.00 3+ hours must use full rental costs above Tables available: Seats Kitchen Facility 38 - 6 top rounds 234 Catering kitchen available. Includes:
Requested. Title of Lecture Date & Time Location (please include address & phone number)
Requested product modifications will be implemented only upon mutual agreement. During the Initial Term of this Agreement, if new terms are not mutually agreed to within one hundred and eighty (180) days after the date the proposal of the new product design changes is made, the contracting parties agree to resolve any dispute about proposed or requested modifications of product design by arbitration pursuant to Article XIV of this Agreement. After the Initial Term, if new terms are not mutually agreed to within one hundred and eighty (180) days after the date any product design changes are proposed, this Agreement will terminate.
Requested. This personal leave is for responsibilities that I cannot assume when school is not in session. Employee’s Signature Building Assignment The above leave is approved/disapproved. Date: Superintendent SUPPLEMENTAL SALARY SCHEDULE Xxxxxxxx Local School District BOARDMAN HIGH SCHOOL Department Chairperson 1. ARCD*** 2.5% 2. Art 10% 3. Business, Careers & Technology 10% 4. English 14% 5. Foreign Language* 10% 6. Guidance 10% 7. Health & Phys. Ed. 10% 8. Industrial Arts 10% 9. Mathematics 14% 10. Music 10% 11. Science 14% 12. Social Studies 14% 13. Special Education 14% Extended Duties
Requested. If you are requesting use of the Church’s facilities for a wedding and/or wedding reception, please list the names and contact information of the bride and groom. Bride: Groom: Please list the name, contact information, and religious affiliation of the person officiating the wedding: Affirmation By our signature(s) hereto, we hereby affirm the following:
Requested. In accordance with the CBA, Article 4, Union Recognition and Employment, we are requesting the union: 🞸 Please provide priority referral of Disadvantaged Workers, based on zip code residence as described on the following page, or veteran status. 🞸🞸 Please provide priority referral of Targeted Workers, to the extent such status is known by the hiring hall or referral source; see list of criteria on the following page. WORKER REPORTING INSTRUCTIONS:
