Facilities Form


Security Measure

Disclaimer to those interested in reserving any facility/equipment of the Lassen Union High School District (LUHSD) school:

  • All fields are required. Requests not complete will be rejected.
  • Cost tables are included in the Facilities Packet. You must click HERE and download, fillout, and sign all legal forms. Then return the forms to LUHSD at 1000 Main St., Susanville, CA 96130
  • The following form will send the District office the facilities information you are requesting. If you have not received any addition information within 5 business days please call the district office at 530-257-5134.
Company Name: 
Name of responsible party: 
Best Contact Number:    Contact person's eMail: 
Alt contact info: 
                        
Date Requested:Time Requested:  to ​
(Make sure you request enough time for setup and cleanup)
Event Start Time: Event End Time: ​
Expected Attendance: 
What is the purpose for the use of the facility ?
What will be the nature of the activity?
Is the activity open to the public?  Yes   No
Will contributions be solicited or accepted? (Are you making money from this event)  Yes    No
If yes, for what purpose will the proceeds be used? 

Equipment/Staff Assistance Requested 

(When cafeteria or computer lab facilities are used, a District Employee must be present)

Equipment needed: 

Refreshments Only    Coffee Maker      Pot Luck      Dishwasher      

Other:

How many district employees are needed?Hours Needed?  to