Attachment III

FACILITY USE REQUEST AND INFORMATION FORM

DEPARTMENT OF THEATRE & DANCE

TEXAS STATE UNIVERSITY

GLADE THEATRE

Please submit both pages of this form in duplicate to Room 101, Theatre Center, fifteen working days prior to the date requested.

AREA REQUESTED:

Glade Theatre (seats 800) _____

The Glade Theatre is an outdoor theatre space located on West Campus, on Moore Street, with stone benches and a permanent stage area.

Electricity is available for use at the Glade by requesting from the Facilities Department (512-245-2148) that the electric box is unlocked and the switch turned on. There are area lights but no stage lights. If you require specialty lighting and equipment, you must make your own arrangements for this.

Unfortunately, there are no dressing rooms or restrooms available at the Glade, so you must make other arrangements.

If you feel that the grounds of the Glade need attention prior to your event, you should contact the Grounds Operations office at (512-245-7846).

NAME OF ORGANIZATION:______________________________________________

CAMPUS AFFILIATION (if applicable): _____________________________________

NATURE OF EVENT (describe in detail): _____________________________________

DATES & TIMES OF REQUESTED RESERVATION

(Please include anticipated set-up, preparation and rehearsal.)

DATE TIME ACTIVITY (set-up, rehearsal, performance, etc.)

___________________ ____________________ __________________________________________

___________________ ____________________ __________________________________________

___________________ ____________________ __________________________________________

___________________ ____________________ __________________________________________

___________________ ____________________ __________________________________________

___________________ ____________________ __________________________________________

If you anticipate needing accommodations for persons with disabilities or have questions about physical access, please contact the Department of Theatre and Dance at (512) 245-2147.

Rental Fees: In accordance with UPPS No. 8.01.10, the following rental fees apply.

I. Academic departments, university-funded student organizations, and events sponsored by Continuing Education or Student Affairs: Fee = $100/day.

II. Non-university-funded campus related activities and non-Texas State funded Continuing Education Activities: Fee = $300/day.

III. Events sponsored by community or non-campus organizations: Fee = $400/day.

Name of person making request (please print or type): ___________________________

Address: ____________________________________ Phone: _____________________

Date request made: _______________________ Signature: _______________________

For Official Use Only

Your event has been scheduled as per your request. This office should be notified of any cancellation or changes to the above agreement at least five working days prior to the scheduled event.

Approved by: Date:

PRIORITY USE CLASSIFICATION:

CHARGES:

LABOR: Hours_____at_____per hour TOTAL LABOR CHARGE:__________

RENTAL CHARGES:_______OTHER CHARGES:________TOTAL:________