Mobile Go Request Form

~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

Middle School

High School

Business

Non-Profit

Other (please specify)

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* 3. Services Required

Admissions Application

Career Exploration

Collin College Overview

FAFSA

Orientation

Registration

Scholarships

Other (please specify)

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* 4. Date Requested

Date

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* 5. Alternate Date

Date

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* 6. Event Address

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

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* 7. Event Start Time

The Mobile Go Center will arrive at your location approximately 1 hour prior to the start time.

Time

AM/PM

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* 8. Event End Time

Event must be 3 hours at a minimum.

Time

AM/PM

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

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* 10. Audience/Grade Level

6th-8th grade

9th-10th grade

11th-12th grade

Community

Other (please specify)

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

Yes

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* 12. Primary Contact Information

Name

Title

Organization

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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

The Mobile Go Center requires at least 8-10 parking spaces, should be away from fire lanes and street entrances, accessible to a tractor-trailer and should not be covered by an overhead structure or trees. The parking area should also be at least 30 feet away from any building or structure.

Example: West parking lot near the cafeteria

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

Agree

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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.

Agree

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* 16. Emergency Contact Information

In the event of an emergency while the Mobile Go is on location, who should we contact? This person cannot be the requester.

Name

Title

Phone