Facility Request Form

Complete if you wish to request use of a Johnston Community School District facility.

Name*
First Last
Email Address*
Phone Number*
Group/Organization*
Are you a 501(c)3 organization?*
If yes, you may be asked to submit a copy of your IRS 501(c)3 confirmation letter.
Address*
Street Address Address Line 2 City State ZIP Code
Purpose of Use*
For what purpose would you like to request to use a JCSD facility?
Estimated number of participants/attendees*
What percentage of participants/attendees will be Johnston CSD residents?*
Charge to participants (in dollars)
If applicable.
Charge to spectators (in dollars)
If applicable.
List all items to be sold at event
If applicable.
Will refreshments be served?
School Requested*
If you would like to request more than one school, please provide more information in the COMMENTS section below.
Room(s) Requested*
Use the command button on your keyboard to select all Beaver Creek rooms you wish to request.
Room(s) Requested*
Use the command button on your keyboard to select all Horizon rooms you wish to request.
Room(s) Requested*
Use the command button on your keyboard to select all Lawson rooms you wish to request.
Room(s) Requested*
Use the command button on your keyboard to select all Timber Ridge rooms you wish to request.
Room(s) Requested*
Use the command button on your keyboard to select all Wallace rooms you wish to request.
Room(s) Requested*
Use the command button on your keyboard to select all Summit rooms you wish to request.
Room(s) Requested*
Use the command button on your keyboard to select all JMS rooms you wish to request.
Room(s) Requested*
Use the command button on your keyboard to select all JHS rooms you wish to request.
Day(s)*
Use the command button on your keyboard to select all days you use to request a JCSD facility.

Date(s)*

Please list requested date(s) in MM/DD/YYYY format.

Request Time*

Please list the full requested time range in 00:00 AM/PM format.

Event Time*

Please list the event time range in 00:00 AM/PM format.

Additional Requests
Use the command button on your keyboard to select all that apply. Reminder: gym users must supply own equipment such as balls, etc.
Comments
Please include any other requests not already listed above, such as the use of another facility, additional dates, or the need for equipment not listed.
CAPTCHA

Entire Building
Gymnasium
Cafeteria
Library Media Center
Computer Lab
Art Room
Music Room
Room 101
Room 102
Room 103
Room 104
Room 105
Room 106
Room 110
Room 111
Room 112
Room 113
Room 114
Room 115
Room 116
Room 121
Room 122
Room 123
Room 124
Room 125
Room 126
Room 231
Room 232
Room 233
Room 234
Room 235
Room 236
Room 241
Room 242
Room 243
Room 244
Room 245
Room 246
Room 251
Room 252
Room 253
Room 254
Room 255
Room 256

Entire Building
Gymnasium
Cafeteria/Student Center
Library Media Center
Computer Lab
Art Room
Music Room
Room 101
Room 102
Room 103
Room 104
Room 105
Room 106
Room 107
Room 108
Room 111
Room 112
Room 113
Room 128
Room 129
Room 130
Room 131
Room 132
Room 133
Room 134
Room 135
Room 136
Room 137
Room 138
Room 139

Entire Building
Gymnasium
Pool
Cafeteria/Student Center
Library Media Center
Computer Lab
Multi-Purpose Room
Band Room
Music Room
Room 102
Room 103
Room 104
Room 105
Room 106
Room 107
Room 108
Room 109
Room 110
Room 122
Room 123
Room 124
Room 125
Room 126
Room 127
Room 128
Room 129
Room 132
Room 133
Room 134
Room 136
Room 137
Room 138
Room 139
Room 140
Room 141
Room 202
Room 203
Room 204
Room 205
Room 206
Room 207
Room 208
Room 209
Room 210
Room 211
Room 222
Room 223
Room 224
Room 225
Room 226
Room 227
Room 228
Room 229
Room 230
Room 231
Room 232
Room 233
Room 238
Room 239
Room 240
Room 241
Room 242
Room 243
Room 244
Room 245
Room 246

Entire Building
Gymnasium (large)
Gymnasium (small)
Weight Room
Cafeteria
Library Media Center
Computer Lab
Auditorium
Band Room
Music Room
Showchoir Room
Art Room
FCS Room
Room 101
Room 102
Room 103
Room 104
Room 105
Room 106
Room 107
Room 108
Room 109
Room 110
Room 112
Room 113
Room 114
Room 115
Room 116
Room 117
Room 118
Room 119
Room 120
Room 121
Room 214
Room 215
Room 216
Room 217
Room 218
Room 219
Room 220
Room 221
Room 222
Room 223
Room 224
Room 314
Room 315
Room 316
Room 318
Room 319
Room 320
Room 321
Room 322
Room 323
Room 324
Room 325
Room 326

Entire Building
Gymnasium (large)
Gymnasium (small)
Fitness Center
Wrestling Room
Stadium
Athletic Field
Cafeteria
Library Media Center
Computer Lab
Auditorium
Band Room
Music Room (north)
Music Room (south)
Room 101
Room 102
Room 103
Room 104
Room 105
Room 106
Room 107
Room 108
Room 114
Room 116
Room 200
Room 201
Room 202
Room 203
Room 204
Room 205
Room 206
Room 207
Room 208
Room 210
Room 213
Room 215
Room 216
Room 217
Room 218
Room 219
Room 220
Room 222
Room 224
Room 302
Room 304
Room 306
Room 308
Room 401
Room 402
Room 403
Room 404
Room 405
Room 406
Room 407
Room 408
Room 409
Room 410
Room 411
Room 412
Room 413
Room 414
Room 416
Room 418
Room 420
Room 422
Room 424
Room 501
Room 502
Room 503
Room 504
Room 505
Room 506
Room 507
Room 508
Room 509
Room 510
Room 512
Room 514
Room 516
Room 518
Room 520
Room 522