EVENT REQUEST FORM

LIBERTY P.A.T.S.

A non-profit benefit corporation

All booster clubs shall, as required by the Kern High School District, submit two copies of the following EVENT REQUEST to the P.A.T.S. Executive Board by the fifth of each month.

Date of Request: ______________________

Date(s) of the Event – Beginning on: _________________   Ending on: _________________

Booster Club: _________________________________________________________________

Event: _______________________________________________________________________

Location of Event: _____________________________________________________________

Income (estimated): ____________________    Expenses (estimated): ___________________

Booster Club Officer Signature: ____________________________  Phone # _____________

LHS Club Advisor Signature: ______________________________  Phone # _____________

P.A.T.S. EXECUTIVE BOARD APPROVAL

Date: _____________________

Conditions: ___________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________

Signature: _____________________________________  Phone #_______________________

RESULTS (To be Completed by Booster Club Contact and Submitted to the Liberty P.A.T.S. within 14 days of the event)

Date: _________________________

Income (actual): _________________          Expenses (actual): ___________________

Net Earned: ___________________

Booster Club Officer Signature: __________________________  Phone # _______________