LINDQUIST STUDENT CENTER
Building Use Permit Application Date __________
               
               
            Front Desk Computer  
  Date(s) to Use     LSC Calendar  
  M    T    W    TH    F    S    S     Date Copies Sent  
       
                S. Wesselhoft  
  Function/Organization     Organiz (2)  
      B.Panich  
            G.Switek  
  Room       D.Hagelin  
                   
J.Kivisto  
Approximate Number to Attend:       Pool  
Library  
Beginning at:   Ending at:       Other:  
   
Person Responsible            
     
Organization Name         SPECIAL REQUESTS -  
Attach additional instructions as needed.
Street Address            
         
City, State, Zip            
PHY ED/GYM/POOL:  
Business Phone                
         
Home Phone                  
         
Specific Activity            
AUDIO/VISUAL:  
Profit _____ Non Profit _____ Internal Transfer_____        
         
FOOD SERVICE:      
_____ Yes _____ No   MEETING ROOM:  (Attach Layout)        
_____ Organization arrange direct with Brian        
_____ LSC Office arrange with Brian          
       
OTHER:
ESTIMATED FEES:          
$________ Room Rental          
$________ Maintenance
$________ Food Service NOTE:  Only carry-in tennis shoes will
$________ Pool be permitted on gym floor and indoor track.
$________ Gym
$________ Staffing Payment is due at Lindquist Center
$________ TOTAL AMOUNT DUE on or before day of event.  Deposit
required for rentals exceeding $50.
Amount Received:  ______________ Date ____________ Custodial/repair charges will be  
Account No. to Charge           assessed if facility is not left in  
its original condition.    
APPROVAL:
Date________________ Approval_______________________________________________
Date________________ Organization Signature___________________________________________________