Use of the grounds and facilities as well as commercial photography and cinemotography.(Individual or Households)

U.S. NATIONAL ARBORETUM

REQUEST for USE of ARBORETUM FACILITIES

APPLICATION and AGREEMENT

1. Organization: ________________________________________________________________________________________________

2. Mailing Address: _____________________________________________________________________________________________

3. Telephone: _________________________________________________________________________________________________

4. Organization Representative: ___________________________________________________________________________________

5. Telephone: Home __________________Work_______________________Cell:_______________Fax:________________________

6. Email Address:_______________________________________________________________________________________________

Permission is requested to use the facilities indicated below for the period and purposes indicated. It is understood that the use of these facilities is subject to the attached rules and regulations and the instructions stated below. I also understand that on rare occasions the facility may be needed by the Department of Agriculture or the National Arboretum for their use; in which case my organization may be asked to change its meeting dates.

7. Program Date __________________

1. Event Set Up Time: Site Rental Time: From ____________To ______________

b. Time(s) Event will be open to the public: From ____________To _____________

c. Event Break-Down & Clean Up Time: From ____________To _____________

d. Estimated Attendance___________

8. Facilities Requested: Indoor: Outdoor:

______ Auditorium ______ Patio (Main Building)

______ Kitchen ______ Patio (Arbor House)

______ Lobby ______ Outdoor Tent

______ Conference Room ______ Other: ____________________________

______ Classroom^ From ____________To _____________

______ Other: Specify: ________________

* All visitors attending any function held in the classroom must register at the Administration Building front desk for a

visitor pass and state their country of citizenship.

9. Relation of the event to Arboretum Mission

The National Arboretum was established by Act of Congress in 1927. The mission of the National Arboretum is to conduct research and education related to trees and other plant life for the purpose of enhancing and improving man’s living and working environment.

______________________________________________________________________________________________________________

10. Is this a fund raising event? Yes (specify and explain) ______ No ______

11. Will there be an attendance fee charged for this event? Yes ___ No ____ if yes please list fee amount: __________________

Will there be any Sale/Auction of products/services? Yes (specify) __________________________________________ No___

12. Will the event require vendor services (e.g. catering, tents, tables, chairs, lighting, staging, audio-visual equipment)? ___Yes *___No

If yes, please provide all vendor companies, contact information and phone numbers on the attached vendor sheet.*)

(* Please refer to the Arboretum’s approved vendors list and submit a USNA Vendor Contact List

13. Will permission be requested to serve alcoholic beverages? Yes _____ No ______

Signature of applicant ____________________________________________________ Date ________________

FOR OFFICE USE ONLY

Recommended Approval Yes____ No___ Reason_________________________________________

Signature ______________________________________________ Title_______________________ Date ____________

Department/Agency

Signature ________________________________________________ Title _______________________ Date ____________

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information is 0518-0024. The time required to complete this information collection is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

U.S. NATIONAL ARBORETUM

REQUEST for USE of ARBORETUM FACILITIES

APPLICATION and AGREEMENT

VENDOR CONTACT LIST

PLEASE NOTE: All organizations and individuals holding events on the grounds of the U.S. National Arboretum are required to use vendors that are approved by the U.S. National Arboretum. A list of approved vendors is attached for your reference.

The vendor contact list must be completed and submitted to the Special Events office no less than 14 calendar days prior to the event date. Failure to provide this information may result in the cancellation of the event and forfeiture of the event deposit.

1. Organization: ________________________________________________________________________________________________

2. Mailing Address: _____________________________________________________________________________________________

3. Telephone: _________________________________________________________________________________________________

4. Organization Representative:____________________________________________________________________________________

5. Telephone: Home _________________________ Work _______________________ Fax ______________________________

Vendor Contact Information

1. Caterer _________________________________________________________________________________________________

Mailing Address: _____________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________

Organization Representative:____________________________________________________________________________________

Date and time of delivery: ______________________________________________ ______________________________________

2. Tent:______________________________________________________________________________________________________

Mailing Address: ______________________________________________________________________________________________

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Telephone: ___________________________________________________________________________________________________

Organization Representative: _____________________________________________________________________________________

Date and time of delivery/set-up:_________________________________________________________________________________

Date and time tent will be disassembled and removed: _______________________________________________________________

3. Tables/ chairs: _____________________________________________________________________________________________

Mailing Address: _______________________________________________________________________________________________

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Telephone: ___________________________________________________________________________________________________

Organization Representative: ______________________________________________________________________________________

Date and time of delivery/set-up:__________________________________________________________________________________

Date and time tables and chairs will be removed: ____________________________________________________________________

Vendor Contact Information

Page Two

4. Audio-Visual:_____________________________________________________________________________________________

Mailing Address: _____________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________

Organization Representative: ___________________________________________________________________________________

Date and time of delivery: ______________________________________________ ______________________________________

5. Portable toilets: ___________________________________________________________________________________________

Mailing Address: _____________________________________________________________________________________________

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Telephone: _________________________________________________________________________________________________

Organization Representative: ___________________________________________________________________________________

Date and time of delivery/set-up:_______________________________________________________________________________

Date and time portable toilets will be removed: __________________________________________________________________

6. Lighting: ________________________________________________________________________________________________

Mailing Address: ____________________________________________________________________________________________

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Telephone: ________________________________________________________________________________________________

Organization Representative: __________________________________________________________________________________

Date and time of delivery/set-up:______________________________________________________________________________

Date and time equipment will be removed: _____________________________________________________________________

7. Additional Vendors: ______________________________________________________________________________________

Mailing Address: ____________________________________________________________________________________________

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Telephone: ________________________________________________________________________________________________

Organization Representative: __________________________________________________________________________________

Date and time of delivery/set-up:______________________________________________________________________________

Date and time equipment will be removed: _____________________________________________________________________

 OMB# 0518-0024