Employee Facility Request Form
Civic Center Department, 661-362-3240

NOTE: Form must be submitted at least 10 business days prior to the start of the event to ensure request can be accommodated.


Contact First Name:*
Contact Last Name:*
Contact Cell Phone Number:*
Contact Phone Number:
Contact Email Address:* (needed for further correspondence)
Nature of Event/Name of Group:*
Date(s) of Event:* Pick a date  and  Pick a date
Supervision by:
Facilities Reserved Date Hours of Event Hours of Set-Up Comments/Special Arrangements
* Pick a date * * *
Pick a date
Pick a date
Pick a date
NOTE: Requester is responsible for reserving facilities with the appropriate college department. For Audio/Visual requests, facility should be available at least 60 to 90 minutes prior to the event for setup.
Event Needs:
Set-up Needs Audio Equipment Computer Equipment
Number of 6 foot Tables Music playback PC Computer
Number of Folding Chairs Piano (Electric Keyboard) Apple Computer
Lectern Speaker System Software (Specify in Other field below)
Stage sections Microphone(s) Projector


  Projection Screen
Easels     Internet Access Required
Teleconference Phone        
Seating or Layout diagram (attach file if necessary):  
  (Form will not accept anything larger than 5MB. If you need to attach more than one item please zip them and attach the zip file.)
I / We agree to abide by and conform to all rules and regulations concerning use of District property and will reimburse the District for any costs due to violation of said rules and regulations.

After submitting the form please contact Civic Center at 661-362-3240 if you want to meet or discuss the planning and/or details for your event.

* Indicates a Mandatory Field

The form may take up to 30 seconds to submit so please be patient and don't click the submit button more than once. Thanks.