APPLICATION FOR REVOCABLE LICENSE FOR THE USE OF REAL PROPERTY INSTRUCTIONS: Save, attach, and submit this form via email to: Executive.Office@SDCourt.ca.gov. This email address can only be used to submit this form; any other correspondence will not be processed. Or return completed application to the San Diego Superior Court – Executive Office, 220 W. Broadway, San Diego, CA 92101. Attach additional pages if necessary and all supporting documentation. Submit at least 30 days in advance of the desired date of use. See Interim Policy for Third Party Use of Superior Court Facilities. 1. Name of Applicant: Phone number: Email: Fax number: Address: Phone number: 2. Organization name: Organization address: Type of organization: Education 3. Name of requested court facility: 37-B1 Madge Bradley Government 37-A1 County Courthouse 37-C1 Kearny Mesa 37-F2 North County Division Non-Profit Private Entity 37-A2 Hall of Justice 37-E1 Juvenile Court 37-D1 Family Court 37-I1 East County Division 37-F1 South County Division Other (Explain): 4. Describe the intended use of the facility: a. Will food and non-alcoholic beverages be provided at this event? No Yes If yes, describe your plan for clean-up and removal of waste generated by the event. Food and beverages are not allowed in courtrooms. _ b. Describe and/or list any posters and signs, special lighting, and furniture or equipment that you will bring to the location: c. List any additional information pertaining to this event not addressed above: Rev 1 (August 2010) Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com APPLICATION FOR REVOCABLE LICENSE FOR THE USE OF REAL PROPERTY 5. Date(s) / Time(s) (including set up and clean up) requested: (If this is a recurring event, please attach a separate sheet with a schedule for the calendar year). Date: from: a.m. to a.m. Date: from: a.m. to a.m. Date: from: a.m. to a.m. 6. Number of conference rooms requested: Number of courtrooms requested: Will the number of rooms needed change for any day of this request? No Yes (If yes, attach a separate sheet listing each date with the requested number of rooms.) 7. Describe other areas of the court building or grounds requested: 8. Expected number of participants: 9. Will this event involve filming? Yes No a. Name of filming project: b. Purpose of film: Advertisement* Educational Public Awareness Training/Instruction Other Commercial Release* *Filming organizations must submit: a) credentials; b) scripts; and c) a list of all equipment to be brought into court facilities including any electrical needs. c. Describe in detail the content to be filmed: I agree to pay the costs associated with this event as will be determined by the court and the AOC and to provide any additional information and complete any necessary forms related to the issuance of a Revocable License for the Use of Real Property. Date: Signature: (Electronic typed name indicates signature) Title: Rev 1 (August 2010) Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com