Signature of Applicant. Date: FOR OFFICE USE ONLY □ Reservation made on Field House Calendar Date Application Received: _ Rental Fee Received: Deposit Fee Paid: Receipt # _ Rental Notification provided to: APPROVAL TO RETURN DAMAGE DEPOSIT Police □ YES Recreation Dept. □ NO Public Works LIONS FIELD HOUSE FACILITY CHECKLIST APPLICANT: RESERVATION DATE: The following is a list of items that need attention at the end of each rental. We ask that renters use this form as a guide to keep our facilities neat and clean. These items are evaluated by the Village of Xxxxxxxx Bay and the Public Works Department. Damage Deposits are withheld based on the satisfactory cleaning of the rental site. Note: Please use the reverse side of this form for additional comments. Pre-Event Inspection Post-Event Inspection Tables should be wiped down; no stains or sticky surfaces. Return to storage location. Chairs should be wiped down, no stains or sticky surface. Return to storage location. Countertops, kitchen sinks, & appliances should be wiped down. Wash, dry and put away all dishes used. Appliances must be clean & operational (microwave, ovens, refrigerator garbage disposal & dishwasher). Remove all decorations including tape. Tape or Decorations are NOT allowed on Blinds or Ceiling. Failure to remove decorations will result in a charge against the damage deposit. Garbage bags removed from building and placed in dumpsters. Please place recyclables in the proper container. Failure to remove the garbage will result in a charge against the Damage Deposit. Check outside of the building and park area for debris. Bathrooms must be picked up; stalls checked. Food and beverages are to be removed from refrigerator. Remove all food brought into the facility No markings on wall surfaces; stains, scuffs, holes Floors swept and mopped Windows and doors must be secured, and lights turned off when leaving.
Signature of Applicant. Date: Applicant’s Name / Group: Today’s Date: Date(s) Requested Starting: _ End Date (if event is re-occurring): Day(s) of the Week Requesting: Sun Mon Tues Wed Thurs Fri Sat Area or Specific Space Requested: 1st and 2nd Choice:Email address: ES ASK Room HS Football Practice Field K-8 Cafeteria ES Campus (grounds) HS Gym K-8 Community Kitchen ES Classroom- Rm# HS Library K-8 Computer Lab ES Gym (baseball in this gym only) HS Parking Lot K-8 Entry Way HS Band Room HS Portable K-8 Football Field HS Baseball Field HS Soccer Practice Field K-8 Library HS Challenge Course HS Softball Field K-8 Play Shed (no restrooms) HS Classroom-Rm# HS Stage K-8 Softball Field HS Commons HS Track MS Classroom HS Conference Room HS Weight Room MS Conference Room HS Concession Kitchen MS Xxx (no baseball permitted) Other, specify: Time Start: Time End: Set-up Time (If Needed): Breakdown Time (If Needed): Description of event to take place: Approximate number of people attending: Is event open to public? Yes No Does your organization hold non-profit status? Yes No If yes, proof is required. Is this a revenue generating event? Yes No If you are requesting use of a field, would you like to be notified of any chemical spraying that is scheduled for that field during your requested time? Yes No If it is determined by the coordinator that your event needs to run through Community Ed, Xxxxx Xxxx (our Community Ed Director) will contact you.
Signature of Applicant. Age: Date:
Examples of Signature of Applicant in a sentence
Date: Signature of Applicant Print Name and Title of Person completing this form: STATE OF : COUNTY OF : I certify that the foregoing instrument was acknowledged before me this day of , 20 by .
Signature of Applicant: Date: UNION BUSINESS MANAGER: I certify that the employee's permanent address is true and correct to the best of my knowledge and is as shown in our records, and that this employee meets the requirements for subsistence in accordance within Article 14.200 and as outlined above.
Date: Signature of Applicant Print Name and Title of Person completing this form: STATE OF FLORIDA ) ) ss: COUNTY OF ) The foregoing instrument was acknowledged before me by means of ☐ physical presence, or ☐ online notarization, this day of _, 20 , by [NAME OF PERSON], as [TYPE OF AUTHORITY,… e.g. officer, trustee, etc.)] for [NAME OF PARTY ON BEHALF OF WHOM INSTRUMENT WAS EXECUTED].
Signature of Applicant: Date: UNION BUSINESS MANAGER: I certify that the Employee's permanent address is true and correct to the best of my knowledge and is as shown in our records, and that this Employee meets the requirements for subsistence in accordance within Article 14.200 and as outlined above.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on [date], at [city], [state]." [Name of Applicant] [Signature of Applicant (if individual) or its Officer] [Typed Name of Person Signing] [Office or Title] CONFIDENTIALITY AGREEMENT (Applicant shall submit one form.
More Definitions of Signature of Applicant
Signature of Applicant. Library Administration Approval:
Signature of Applicant. Date: By signing this form, I acknowledge I have read and understand the cancellation policy with respect to fees as outlined on page 5 of the Civil Marriage Information Package.
Signature of Applicant. Date: / / 20 Position Held: (invoice can be provided on return of booking form) PLEASE RETURN THIS FORM TO THE ABOVE ADDRESS AND KEEP A COPY FOR YOUR RECORDS. GENERAL CONDITIONS FOR HIRE ABN: 90 056 429 246 It is the responsibility of each group to ensure that campers understand and follow the Campsite’s rules and procedures. Each group must have a competent leader in charge to liaise with Campsite staff. Campsite recommends a ratio of one leader to ten campers (1:10). The group leader is responsible for camper supervision at all times. Campsite staff or their sub-contracted outdoor activity providers may instruct, lead, demonstrate or assist in an activity but the group leader is deemed to be responsible for overall group supervision and safety. The campsite will provide written procedures for the conduct of specialised outdoor activities.
Signature of Applicant. Date: INSERT DATE Signature of Supervising Surveyor: Date: INSERT DATE 3 INTRODUCTION The Professional Training Agreement detailed within this document establishes a structured training programme that will permit the candidate to proceed to licensing as a cadastral surveyor in South Australia. It should be viewed as not only an agreement between the parties but as the basis of planning, modifying, monitoring and assessing the training. CONDUCT OF THE AGREEMENT The Agreement has been prepared according to the Guidelines for Professional Training Agreements as determined by the Surveyors Board of South Australia (the Board). DETAILS OF CANDIDATE Name RSG NAME Address Telephone (home) (work) Email Qualifications Graduate Surveyor
Signature of Applicant. Date: For the District
Signature of Applicant. Date:……./……../…….. Position Held:………………………………………………………….Deposit enclosed: $................................................. PLEASE RETURN THIS FORM WITH THE DEPOSIT AND KEEP A COPY FOR YOUR RECORDS BENALLA P-12 COLLEGE CAMP GENERAL CONDITIONS OF HIRE It is the responsibility of each group to ensure that campers understand and follow Benalla P-12 College Camp rules and procedures. Each group must have a competent leader in charge to liaise with Benalla P-12 College Camp staff. Benalla P-12 College Camp recommends a ratio of one leader to ten campers (1:10). The group leader is responsible for camper supervision at all times. Benalla P-12 College Camp staff or their sub-contracted outdoor activity providers may instruct, lead, demonstrate or assist in an activity but the group leader is deemed to be responsible for overall group supervision, safety and first aid. DAILY DUTIES Benalla P-12 College Camp is to be maintained in a clean condition by the campers. Catered groups are to provide duty groups to set and clear tables for each meal. Other daily cleaning duties may be required and will be specified by Benalla P-12 College Camp staff. Self-catered groups are responsible for cleaning and maintaining all areas in an hygienic manner. A food supervisor must be nominated and be competent to follow workplace hygiene procedures.
Signature of Applicant. Date: This permit is issued solely for the locations herein specified and is subject to the applicant complying with all applicable regulations and by-laws and the terms set out in accordance with the permit. It shall be subject to cancellation at any time without advance notice if in the opinion of the Township Clerk the applicant has failed to comply with any of the provisions of the governing by-laws and policy. For Office Use By-law Enforcement: Approved ☐ YES ☐ NO Date: Comments: Corporate Services: Approved ☐ YES ☐ NO Date: Comments: Fire Department: Approved ☐ YES ☐ NO Date: Comments: Public Works: Approved ☐ YES ☐ NO Date: Comments: Recreation: Approved ☐ YES ☐ NO Date: Comments: Xxxx Councillor: Approved ☐ YES ☐ NO Date: Comments: Permit Approved: ☐Yes ☐ No Signature of Township Clerk: