UNIVERSITY OF PITTSBURGH FORM INSTRUCTION GUIDE 

FORM NUMBER:      FORM 0038 PITT 5001

FORM TITLE:            Athletic Facilities Request

PROCEDURE:           04-01-04

EFFECTIVE DATE:   June 4, 1989

PAGE (S):                   1

 

ENTER THE FOLLOWING INFORMATION WHERE INDICATED

1.   Name of University affiliated group or organization sponsoring the event

2.   Name of University athletic facility desired

3.   Name of alternate facility, if above is unavailable

4.   Date(s) facility is needed

5.   Time period needed for the event (Beginning and End times)

6.   Check to indicate the participants

7.   Description of the event

8.   Special Arrangements needed

9.   Check to indicate whether food will be served

10. Check to indicate whether admission will be charged

11. Check to indicate whether additional security is needed

12. Additional comments

13. Name of person submitting the request

14. Date request is submitted

15. Campus address of person submitting the request (Room Number and Building)

16. Campus telephone (AAA-NNN-NNNN)

17. Home address of person submitting request

18. Home phone number. (AAA-NNN-NNNN)

19. FAIS Account Number (N-NNNN-NNN)

20. Billing address

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TO BE COMPLETED BY ATHLETIC DEPARTMENT:

21. Cost estimate, if applicable

22. Indicated whether request is approved or not approved

23. Enter date

24. Signature of Facilities Coordinator