UNIVERSITY OF PITTSBURGH \ FORM INSTRUCTION GUIDE



FORM TITLE:         ATHLETIC FACILITIES REQUEST
NUMBER:             FORM 0038 PITT 5001
PROCEDURE:          04-01-04


ENTER THE FOLLOWING INFORMATION WHERE INDICATED

    1.    Name  of  University affiliated group  or  organization
          sponsoring the event
ENTER THE FOLLOWING INFORMATION WHERE INDICATED

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

    3.    Name of Unviersity athletic facility desired

    4.    Name of alternate facility, if above is unavailable

    5.    Date(s) facility is needed

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

    7.    Check to indicate the participants

    8.    Description of the event

    9.    Special Arrangements needed

   10.    Check to indicate whether food will be served

   11.    Check to indicate whether admission will be charged

   12.    Check to indicate whether additional security is needed

   13.    Additional comments

   14.    Name of person submitting the request

   15.    Date request is submitted

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

   17.    Campus telephone (AAA-NNN-NNNN)

   18.    Home address of person submitting request

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

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

   21.    Billing address

_
TO BE COMPLETED BY ATHLETIC DEPARTMENT:

   22.    Cost estimate, if applicable

   23.    Indicated whether request is approved or not approved

   24.    Enter date

   25.    Signature of Facilities Coordinator

   26.    Name of Unviersity athletic facility desired

   27.    Name of alternate facility, if above is unavailable

   28.    Date(s) facility is needed

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

   30.    Check to indicate the participants

   31.    Description of the event

   32.    Special Arrangements needed

   33.    Check to indicate whether food will be served

   34.    Check to indicate whether admission will be charged

   35.    Check to indicate whether additional security is needed

   36.    Additional comments

   37.    Name of person submitting the request

   38.    Date request is submitted

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

   40.    Campus telephone (AAA-NNN-NNNN)

   41.    Home address of person submitting request

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

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

   44.    Billing address

_
TO BE COMPLETED BY ATHLETIC DEPARTMENT:

   45.    Cost estimate, if applicable

   46.    Indicated whether request is approved or not approved

   47.    Enter date

   48.    Signature of Facilities Coordinator