Muncy School District Facility License AgreementRequesting OrganizationName of Requesting OrganizationAddress Line 1TownStateZip CodeName of Contact Person(s) for OrganizationOrganization's phone number if different from contact person's Contact Person for OrganizationAddress Line 1TownStateZip CodePhone Number for Contact Person of OrganizationEmail Address for Contact Person or OrganizationFacility Requesting to UseDates and Hours RequestingEquipment/Services RequestingType of EventNumber of ParticipantsChaperone(s)#1 First and Last#2 First and Last#3 First and Last#4 First and Last#5 First and Last#6 First and LastOther CommentsSubmit Form