Western Dubuque County Community School District
Western Dubuque High School Auditorium - Request for Use Form
2/17/2019
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Event Title
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Organization Sponsoring the Event
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Contact Person: *
Who will be in charge of the event?
Contact Phone #: ()- Ext.
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Contact Email: *
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Date and Time Event Begins (1st choice)
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End Time
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Alternate Date & Time Event Begins
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End Time
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What time will the auditorium need to be open to the public or user group?
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What time will the user group be arriving/needing the auditorium open?
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Event Details: Please provide a detailed description of what the event will entail.
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Lighting Needs: Please check which best describes what you will need for your event
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Sound Needs: How many microphones will you need?
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What additional equipment will you need? Check all that apply: *
Projector and screen  Choral risers  
Show choir risers  Sound shell and clouds  
None of the above  
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Routing Instructions
Please complete the form in its entirety to request use of the Western Dubuque High School Auditorium facilities.
Complete the information below to route your form. * Indicates Required Fields
Send to Approver:  
No approver has been assigned to this form, please contact your District Forms Manager.