Foreword contained herein are the regulations and/or procedures formulated by the administrators of the Buffalo City School District. The organizing system in this manual utilizes the same numerical coding as in the Buffalo City School District Policy



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DATE: ________________, 20____

NAME OF ORGANIZATION:


TYPE OF ORGANIZATION:

(Community, Educational, P.T.A., Government, Other)



SCHOOL TO BE USED:

CHECK ROOMS TO BE USED:

[ ] CAFETERIA

[ ] AUDITORIUM

[ ] PUBLIC ADDRESS SYSTEM

[ ] GYMNASIUM

[ ] NUMBER OF CLASSROOMS REQUIRED

[ ] NUMBER OF SHOPS REQUIRED

[ ] POOL AND SHOWER

[ ] OTHER:
APPROXIMATE NUMBER OF PEOPLE EXPECTED:
DAY OF WEEK: DATES:
TIME: FROM: a.m. p.m. TO: a.m. p.m.
PURPOSE FOR WHICH PREMISES WILL BE USED: .
ADMISSION FEE TO BE CHARGED, IF ANY:
PURPOSE FOR WHICH PROFITS WILL BE USED:

NAMES AND ADDRESSES OF OFFICERS OR DIRECTORS

NAME BUSINESS OR HOME BUSINESS OR HOME

ADDRESS TELEPHONE NUMBER



I hereby certify that the necessary public liability insurance with the Board of Education and the City of Buffalo as additional assureds with the following limits: bodily injury $100,000 - $300,000/property damage $5,000 - $25,000 will be obtained prior to use of the building and that any damage to school property caused by the above organization will be properly adjusted.
APPROVED:

OFFICER OR DIRECTOR

3280F.2


BUFFALO PUBLIC SCHOOLS

INSTRUCTIONAL APPLICATION FOR USE OF SCHOOLS
DATE: , 20
GROUP:
SCHOOL TO BE USED:

CHECK ROOMS TO BE USED:

[ ] CAFETERIA


[ ] AUDITORIUM
[ ] PUBLIC ADDRESS SYSTEM
[ ] GYMNASIUM
[ ] NUMBER OF CLASSROOMS REQUIRED
[ ] NUMBER OF SHOPS REQUIRED
[ ] POOL AND SHOWER
[ ] OTHER:
APPROXIMATE NUMBER OF PEOPLE EXPECTED:
DAY OF WEEK: DATES:
TIME: FROM: a.m. p.m. TO: a.m. p.m.
PURPOSE FOR WHICH PREMISES WILL BE USED: .
FUND NUMBER TO CHARGE, (IF APPLICABLE):
BUILDING USE REQUESTED BY:

OFFICE LOCATION PHONE FAX #


NAME:
TITLE:

FOR OFFICE USE ONLY:
Approved By:

Please return form to: , Director of School Plant Operations

Plant Department, 406 City Hall

or

Fax to: 851-3526



3280F.3

BUFFALO PUBLIC SCHOOLS

PARENT GROUP APPLICATION FOR USE OF SCHOOL

Date ________________, 20___

DEPARTMENT:
SCHOOL TO BE USED:

CHECK ROOMS TO BE USED:

[ ] CAFETERIA


[ ] AUDITORIUM
[ ] PUBLIC ADDRESS SYSTEM
[ ] GYMNASIUM
[ ] NUMBER OF CLASSROOMS REQUIRED
[ ] NUMBER OF SHOPS REQUIRED
[ ] POOL AND SHOWER
[ ] OTHER:
APPROXIMATE NUMBER OF PEOPLE EXPECTED:
DAY OF WEEK: DATES:
TIME: FROM: a.m. p.m. TO: a.m. p.m.
PURPOSE FOR WHICH PREMISES WILL BE USED:
FUND NUMBER TO CHARGE, (IF APPLICABLE):
BUILDING USE REQUESTED BY:
NAME: TELEPHONE:


FOR OFFICE USE ONLY:
Approved by:

Please send copy to: Room 406 City Hall, Attention Director of School Plant Operations.

2005 3281R

Community Relations



SUBJECT: THE USE OF SCHOOL-OWNED MATERIALS AND EQUIPMENT

Private and/or personal use of school-owned materials and equipment by community members, employees, or students is not permitted. Except when used in connection with or when rented under provisions of Education Law Section 414, school-owned materials and equipment may be used only in connection with school-related purposes.


The regular school program will have first priority on the use of school materials and equipment. Personnel approving applications for use of such materials and equipment by community members, employees and students must ensure that it is available for school use during regular school hours. The equipment must be returned promptly by the individual who borrows it by the agreed upon time.
A community member, employee or student borrowing materials and/or equipment will complete a Permission Form for Authorized Use of School-Owned Materials and Equipment (Form #3281F) and submit it to the Building Principal or his/her designee at least twenty-four (24) hours in advance. The Building Principal or his/her designee will approve or disapprove the application. Upon return of the materials and/or equipment, the Principal or his/her designee will inspect it for damage. The community member, employee or student or his/her parent/guardian may be held responsible for the cost of repair or replacement, with the exception of normal wear and tear, in accordance with applicable law.
In addition to the above restrictions, District equipment may not be used for:


  1. Any public meeting or entertainment that reflects in any discriminatory way on a citizen's race, color, creed, national origin, sex, sexual orientation, disability or age. However, in accordance with law, the District will not discriminate in its community use of school-owned materials and equipment against any group officially affiliated with the Boy Scouts of America or any other youth group listed in Title 36 of the United State Code. Nor will the District deny such access or opportunity for reasons based on the membership or leadership criteria or oath of allegiance to God and country. However, such use must be in accordance with the District's community use of school-owned materials and equipment guidelines.




  1. Any use that is likely to result in damage to the equipment.




  1. A meeting of any group whose purpose is to overthrow the government of the United States or New York State.




  1. For personal gain or any type of business activity.

3281F

BUFFALO PUBLIC SCHOOLS


PERMISSION FORM FOR AUTHORIZED USE OF

SCHOOL-OWNED MATERIALS AND EQUIPMENT

Date: ________________________________



TO: ______________________________________

(Principal)

I request permission to use the following piece(s) of school-owned materials and/or equipment.



Material/Equipment School Model # Serial #
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
I shall require use of this material and/or equipment from ___________________________________
to _______________________________________.

I understand that I assume the responsibility for returning the materials and/or equipment in the same condition it was borrowed. The community member, employee or student (or his/her parent/guardian) may be held responsible for the cost of repair or replacement, with the exception of normal wear and tear, in accordance with applicable law.

*___________________________________________

(Signature)

*If the request is being made by a student under eighteen (18) years of age, the form is to be signed by a parent/guardian.

2005 3290R

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Community Relations



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