Facility Request Form



Start Time:   End Time:

Organization’s Name:

Director’s Name:


City    State   Zip

E-mail address:    Fax:

Director contact numbers: Home:  Cell: 

Day of event:

Location(s): Bollman Gym    LifeSports Center    Shirk Stadium     Tennis Courts
North Field     Kelchner Field     Softball Field     Football practice field      Roessner field

Approximate # of participants:    Expected income:

This income benefits:

Set-up requested: (Please be specific as possible)

(Check all that apply and specify number needed in the space provided)
Tables (#)
Chairs (#)
Locker Rooms

  • Men’s (#)
  • Women’s (#)

Extension Cords (#)
Scoreboard (Bollman Gym/Shirk Stadium)
Flip Score Charts (#)
Sound System (Bollman Gym/Shirk Stadium)
Portable Sound System
Bleachers (Bollman Gym Only) How many sides? (1,2,3,4)
Benches (Life Sports Center Only) (#)
Divider Nets between Courts (Life Sports Center Only)
Volleyball Nets (#)
Racquetball Courts (#)
Training Room (If applicable)
Storage (If applicable)
Concessions (If applicable) Ticket Sales
On Duty Custodian
Event Staff needed
Other Requests:

  • Please fax a diagram of the necessary set-up and a copy of your organization’s
    certificate of liability insurance in the amount of one million dollars to 610-921-7566.
  • A copy will be sent to you with either approval or denial.

Thank you for your reservation. We will inform you if there is a problem meeting your requests. If you have any other questions, please contact Bev at the athletic office at (610) 921-7535 or email bminjock@albright.edu.

In order to help prevent abuse of this form, please enter the FOURTH letter of the name of this college in the space provided. Please use lowercase.