2003/03/26 Council Agenda Packet

J � _ 42, Everett Public Schools %.; • `�� Facility Use Prioritization Certification Form Community Service Department Evert MK Schools 4730 Colby Ave/P.O.Box 2098,Everett WA 98203 ._.._. Phone:(425)388-4747/(425)388-4746 Fax:(425)339-4238 "X"the groups that pertain to Priority Description your organization or team. Group III— Non-profit groups/events that are exclusively for youth 20 years of age or younger with open enrollment and open Non-Profit participation of all ability levels with at least 80%of the youth living within the boundaries of Everett Public School District. In-District (i.e.scouting organizations,soccer leagues,little leagues,etc.) - - X Youth Group (Clearly designate group number on each roster and submit rosters with the certification form) Group IV-- Non-profit groups/events that are exclusively for youth 20 years of age or younger with at least 80%of the youth living Select within the boundaries of the Everett School District whose participants are selected on a competitive or tryout basis and Non-Profit whose activities are not open to youth of all ability levels.If an organization is both"select"and"non-select"activities(i.e. In-District select/premiere and club soccer teams),user fees shall be determined by applying Group III rates for the non-select Youth Groups activities. (Clearly designate group number on each roster and submit rosters with the certification form) Group V— Non-profit groups/events that are exclusively for youth 20 years of age or under with more than 50%and less than 80%of Non-Profit the youth living within the boundaries of the Everett School District whose participants are provided activities for a season. Partial (Clearly designate group number on each roster and submit rosters with the certification form) In-District Youth Group Group VI-- Youth groups sponsored by a K-12 private school located within the Everett School District boundaries. Private Schools K-12 Group VII— Not for profit local adult groups with 80%of the adults living within the boundaries of the Everett School District which have Non-Profit In as their prime focus the interest and needs of the adults of the local community,including adult organizations with a non- District Adult profit status,adult organizations approved by United Way and adult activities sponsored by government agencies.(i.e. Group adult recreational sports,homeowners associations,government agencies,organized community groups.) (Clearly designate group number on each roster and submit rosters with the certification form) Group VIII-- Youth groups or youth organizational activities which do not qualify under Groups III,IV,V or VI Other Youth Groups Group IX-- Adult groups or organizational activities which do not qualify under Group VII. Other Adult Groups Group X-- Includes all commercial and/or promotional activities such as for-profit presentations(i.e.insurance TSA informational For Profit meetings,wedding receptions and private parties.) Groups I hereby certify that the above information is accurate to the best of my knowledge.I have no prior knowledge that any of the information I have offered on this form is inaccurate. I will notify the District as I gain knowledge of any changes to this information. I understand if the information I have given is found to be unsound,our organization will be charged the discrepancy and/or we will be unable to utilize District facilities in the future. Organization Everett Public Library Phone425-8030 vrkwsk� Yourname(printed) Dorothy Matsui Email dmat-eci@ci.ever ett.wa.uJ:'hone 425-257-8030 Signed X Date 7-\ , 0 3 •