~Requests must be submitted at least 2 weeks prior to event; approval is based on date availability and parking locations.

~Events must be a minimum of 3 hours with 50 expected participants. There are 20 computers on board so a rotation of services will occur.

~The Mobile Go Center will be transported to the event on the day of.

~We reserve the right to reschedule/cancel any event due to inclement weather or the unavailability of staff/driver.

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* 1. Organization/School Name

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* 2. Type of Organization

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* 3. Services Required

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* 4. Date Requested

Date

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* 5. Alternate Date

Date
Date

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* 6. Event Address

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* 7. Event Start Time

Time

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* 8. Event End Time

Time

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* 9. Anticipated Total Number of Participants (50 minimum)

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* 10. Audience/Grade Level

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* 11. Will handicap assistance be needed for the event?

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* 12. Primary Contact Information

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* 13. Where will the Mobile Go be parked at the event?

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* 14. I acknowledge that the Mobile Go Driver will have the final determination on where the trailer will be parked.

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* 15. I acknowledge that the event can be cancelled or moved due to inclement weather or the unavailability of staff/driver.

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* 16. Emergency Contact Information

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