M-NCPPC Gymnasium Permit Request Form
Complete the following form then press
'Continue'
for your finalized application to print, sign, and fax, mail or hand deliver to M-NCPPC.
General Information:
Gymnasium Name:
Requested day(s)
Requested date(s):
Number of Hours
Time
[9am to 11pm only, 7days]:
to
Purpose of reservation:
Select One
Basketball
Volleyball
Number of Attendance: Adults
, Teens
, Children
Name of Oragnization/Group
(if applicable)
:
Person in Charge :
E-mail Address
Address :
City:
State:
Zip:
Work Phone:
Home Phone:
Payment Information:
Payment Method:
Select One
Cash
Check
Visa
Mastercard
Cardholder's Name
Card #:
Exp Date: