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Agreement - CSDA - 2023-10-10FACILITY INFORMATION District Name: Contact Person: Address: City: State: Zip: Phone: Fax: Email: Facility Name (if different): Facility Address (if different): EVENT(S) INFORMATION Date Time 1st Event - Name of Event: 2nd Event - Name of Event: 3rd Event - Name of Event: SEPARATE REGISTRATION FEES Is there a charge for the use of your facility? Yes: How much: $ No Would someone from your district be willing to sign attendees in, hand out materials and distribute certificates/evaluations or help set up for self distribution? Yes No REQUESTED ROOM SET-UP PLEASE MARK ITEMS YOUR FACILITY CAN PROVIDE: Tables and chairs set classroom style for at least: 15 25 35 50 Table located in front for LCD projector and Speaker materials. Screen located in front. Tables located in back for food/beverage. Table with chairs near room entry for registration. Lectern or Podium Microphone Screen Easel/Flip Charts Dry Erase Board with Markers TV and VHS VCR, DVD Overhead or Portable LCD Projector Classroom Style ( 15, 25, 35, 50) Theater Style (how many?): Hollow Square (how many?): U Shape (how many?): Air Conditioning/Heat PARKING Capacity:Additional Notes: FOOD/BEVERAGE Does your facility offer coffee service? Yes: How much?: $ No Are local restaurants/delis/caterers within a short distance of the facility? Yes No Are there any restaurants/delis/caterers that will deliver to the facility? Yes No Suggestions for caterer or local restaurants: HOTEL Are there any hotels close to the facility? Yes No Hotel Recommendations: SIGNATURES Megan Hemming, Professional Development Director, CSDA: Date: Name:Title:Date: District: FACILITY USE AGREEMENT California Special Districts Association Districts Stronger Together