Signature of Applicant. Date: FOR OFFICE USE ONLY □ Reservation made on Field House Calendar Date Application Received: _ Rental Fee Received: Deposit Fee Paid: Receipt # _ Rental Notification provided to: APPROVAL TO RETURN DAMAGE DEPOSIT Police □ YES Recreation Dept. □ NO Public Works LIONS FIELD HOUSE FACILITY CHECKLIST APPLICANT: RESERVATION DATE: The following is a list of items that need attention at the end of each rental. We ask that renters use this form as a guide to keep our facilities neat and clean. These items are evaluated by the Village of Xxxxxxxx Bay and the Public Works Department. Damage Deposits are withheld based on the satisfactory cleaning of the rental site. Note: Please use the reverse side of this form for additional comments. Pre-Event Inspection Post-Event Inspection Tables should be wiped down; no stains or sticky surfaces. Return to storage location. Chairs should be wiped down, no stains or sticky surface. Return to storage location. Countertops, kitchen sinks, & appliances should be wiped down. Wash, dry and put away all dishes used. Appliances must be clean & operational (microwave, ovens, refrigerator garbage disposal & dishwasher). Remove all decorations including tape. Tape or Decorations are NOT allowed on Blinds or Ceiling. Failure to remove decorations will result in a charge against the damage deposit. Garbage bags removed from building and placed in dumpsters. Please place recyclables in the proper container. Failure to remove the garbage will result in a charge against the Damage Deposit. Check outside of the building and park area for debris. Bathrooms must be picked up; stalls checked. Food and beverages are to be removed from refrigerator. Remove all food brought into the facility No markings on wall surfaces; stains, scuffs, holes Floors swept and mopped Windows and doors must be secured, and lights turned off when leaving.
Signature of Applicant. Date: Applicant’s Name / Group: Today’s Date: Date(s) Requested Starting: _ End Date (if event is re-occurring): Day(s) of the Week Requesting: Sun Mon Tues Wed Thurs Fri Sat Area or Specific Space Requested: 1st and 2nd Choice:Email address: ES ASK Room HS Football Practice Field K-8 Cafeteria ES Campus (grounds) HS Gym K-8 Community Kitchen ES Classroom- Rm# HS Library K-8 Computer Lab ES Gym (baseball in this gym only) HS Parking Lot K-8 Entry Way HS Band Room HS Portable K-8 Football Field HS Baseball Field HS Soccer Practice Field K-8 Library HS Challenge Course HS Softball Field K-8 Play Shed (no restrooms) HS Classroom-Rm# HS Stage K-8 Softball Field HS Commons HS Track MS Classroom HS Conference Room HS Weight Room MS Conference Room HS Concession Kitchen MS Xxx (no baseball permitted) Other, specify: Time Start: Time End: Set-up Time (If Needed): Breakdown Time (If Needed): Description of event to take place: Approximate number of people attending: Is event open to public? Yes No Does your organization hold non-profit status? Yes No If yes, proof is required. Is this a revenue generating event? Yes No If you are requesting use of a field, would you like to be notified of any chemical spraying that is scheduled for that field during your requested time? Yes No If it is determined by the coordinator that your event needs to run through Community Ed, Xxxxx Xxxx (our Community Ed Director) will contact you.
Signature of Applicant. Library Administration Approval:
Examples of Signature of Applicant in a sentence
Please print legibly to speed up processing timeAPPLICANT’S FULL NAME:APPLICANT’S SSN:APPLICANT’S DOB:APPLICANT’S FULL ADDRESS: READ, ACKNOWLEDGED AND AUTHORIZED Signature of Applicant Date For California applicants only, if you would like to receive a copy of the report, if one is obtained, please check this box.
Dated Signature of Applicant with Seal:(To be signed by the officer authorized by the Firm/Company to sign on behalf, the Firm/Company with company’s seal) Note: - In case of sole proprietary concern, affidavit should be signed only by the sole proprietor.(Title of the Officer)(Title of the firm/Company) (Date)The above named deponent has understood the contents well and solemnly and sincerely declared and affirmed by the deponent in my presence at and signed before meon this day of …………………………..
Yes/No(b) If yes, give details thereon Dated Signature of Applicant with seal Note: It any information in this Annexure is found to be incorrect or concealed, the Qualification Application will be summarily rejected & price tender will not be opened.Annexure – D AFFIDAVIT(To be furnished in a Twenty Rupees Non-Judicial Stamp Paper duly Certified by Notary Public)1).
Signature of Applicant Date The information collection requirements contained in this form were submitted to the Office of Management and Budget (OMB) under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3520).
IN CASE OF EMERGENCY NOTIFY Signature of Applicant NAME ADDRESS PHONE NO.
More Definitions of Signature of Applicant
Signature of Applicant. Age: Date:
Signature of Applicant. Date: By signing this form, I acknowledge I have read and understand the cancellation policy with respect to fees as outlined on page 4 of the Civil Marriage Information Package.
Signature of Applicant. Date: This permit is issued solely for the locations herein specified and is subject to the applicant complying with all applicable regulations and by-laws and the terms set out in accordance with the permit. It shall be subject to cancellation at any time without advance notice if in the opinion of the Township Clerk the applicant has failed to comply with any of the provisions of the governing by-laws and policy. For Office Use By-law Enforcement: Approved ☐ YES ☐ NO Date: Comments: Corporate Services: Approved ☐ YES ☐ NO Date: Comments: Fire Department: Approved ☐ YES ☐ NO Date: Comments: Public Works: Approved ☐ YES ☐ NO Date: Comments: Recreation: Approved ☐ YES ☐ NO Date: Comments: Xxxx Councillor: Approved ☐ YES ☐ NO Date: Comments: Permit Approved: ☐Yes ☐ No Signature of Township Clerk:
Signature of Applicant. Date: Signature of Land Owner: Date: Signature of Improvement Holder: Date: _ FOR COUNTY USE ONLY Total Use Tax Collected: Date Paid: Receipt #:
Signature of Applicant. Date: INSERT DATE Signature of Supervising Surveyor: Date: INSERT DATE 3 INTRODUCTION The Professional Training Agreement detailed within this document establishes a structured training programme that will permit the candidate to proceed to licensing as a cadastral surveyor in South Australia. It should be viewed as not only an agreement between the parties but as the basis of planning, modifying, monitoring and assessing the training. CONDUCT OF THE AGREEMENT The Agreement has been prepared according to the Guidelines for Professional Training Agreements as determined by the Surveyors Board of South Australia (the Board). DETAILS OF CANDIDATE Name RSG NAME Address Telephone (home) (work) Email Qualifications Graduate Surveyor
Signature of Applicant. Date: Approved by: _ Date:
Signature of Applicant. Date:……./……../…….. Position Held:………………………………………………………….Deposit enclosed: $................................................. PLEASE RETURN THIS FORM WITH THE DEPOSIT AND KEEP A COPY FOR YOUR RECORDS BENALLA P-12 COLLEGE CAMP GENERAL CONDITIONS OF HIRE It is the responsibility of each group to ensure that campers understand and follow Benalla P-12 College Camp rules and procedures. Each group must have a competent leader in charge to liaise with Benalla P-12 College Camp staff. Benalla P-12 College Camp recommends a ratio of one leader to ten campers (1:10). The group leader is responsible for camper supervision at all times. Benalla P-12 College Camp staff or their sub-contracted outdoor activity providers may instruct, lead, demonstrate or assist in an activity but the group leader is deemed to be responsible for overall group supervision, safety and first aid. DAILY DUTIES Benalla P-12 College Camp is to be maintained in a clean condition by the campers. Catered groups are to provide duty groups to set and clear tables for each meal. Other daily cleaning duties may be required and will be specified by Benalla P-12 College Camp staff. Self-catered groups are responsible for cleaning and maintaining all areas in an hygienic manner. A food supervisor must be nominated and be competent to follow workplace hygiene procedures.