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Out-of-District Facility Reservation Request Form
Room Number
Equipment Needs

Will Money be Collected?

Describe table/chair arrangements:


Minimum $1,000,000 Liability Coverage Required

Insurance Carrier
Policy Number
Amount of Coverage
Dates of Reservation
List Other Equipment Needs
Purpose of Event
Start Time
End Time
Contact Person
Phone Number
Confirm Email:
Mailing Address
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The Mission of Palestine Independent School District is to foster relationships that Excite, Engage, and Empower our students and community to achieve Excellence.

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