Arizona Western College
Facility Use regarding Political Activities
Name of Organization:
Purpose of activity: A political action committee that is requesting to come onto campus for the purpose of (1) soliciting students, faculty, staff and community members to register to vote; (2) soliciting students, faculty, staff and community members signatures on petitions for the purpose of submission of a ballot proposition or initiative; and (3) soliciting students, faculty, staff and community members signatures for the purpose of nomination of candidates for elective office.
Representative in Charge & phone number:
Date of Activity:
Names of Representatives to be on Campus w/ phone numbers
Rules & Regulations
These activities are permissible on campus property provided that representatives of your organization (including you) comply with the following minimal restrictions on the time, place and manner of your activities:
· Representatives may solicit between the hours of 7 a.m. and 8 p.m., Monday through Thursday, in the shaded courtyard area of the 3C building. No more than three representatives may be in the designated area at any one time. All political activity must take place in the designated area and representatives cannot approach students, faculty, staff and community members.
· Any one group shall be limited to soliciting no more than two consecutive thirteen-hour time periods three times a semester.
· Representatives may use three chairs and one table no more than ten-feet long. This equipment must be supplied by the representatives and not the College.
· Representatives may not use more than one sign to advertise their activity. The sign may be no larger than two-feet by three-feet, and must be under or affixed to the table referenced above. The sign may not be affixed to any campus property. The sign may have lettering but no pictures.
· Representatives may not use any type of amplification system, including, but not limited to any public address (“PA”) system or “bull horn.”
· Representatives may not distribute or make available to students, faculty, staff and community members any tangible item, except for informational literature, about the proposed candidate or ballot initiative. Informational literature must be no larger than eight and one-half by eleven inches and may not be obscene, vulgar or defamatory.
· A representative shall notify the College of the request to participate in an activity no less than six working days (Mon-Thurs) prior to the anticipated activity. Notice must be made to the College by contacting the Director of Risk Management, Sharon Register by telephone at 928-314-9474. The representative requesting permission to participate in an activity must give Ms. Register the name(s) of each representative participating in the activity and a telephone contact number for the representative in charge of the activity. Space in the designated area is limited. The Director of Risk Management shall grant requests to use the designated space on a first-come, first-served basis, giving priority to student use and College-affiliated activities.
· The representative in charge of the activity shall give each representative that is going to be present on campus a written copy of this notification.
· Representatives may not obstruct other student, faculty or staff activities or otherwise disrupt the College environment. Any representative who violates these terms may be deemed a trespasser on College property and be subject to appropriate prosecution within the discretion of the College Police Department. The College assumes no responsibility financial or otherwise for the acts or omissions of any representative who participates in an activity.
· The representative in charge of the activity must complete the Arizona Western College Hold Harmless Agreement.
Please submit a copy of your informational literature along with the signed Facility Use for Political Activities form and the Hold Harmless form. By signing below you are agreeing to comply with the rules and regulations set forth. All forms are to be submitted back to Risk Management two working days prior to the event. The representative in charge will be notified upon approval and will receive copies of all signed documents.
Representative in Charge Date Director of Risk Management Date
Chief of Police Date College Officer Date
Attached are the Hold Harmless Agreement and a map designating the courtyard area.
Office of Risk Management
PO Box 929 2020 S. Ave 8E
Yuma AZ 85366 Yuma AZ 85365 (928) 314-9474 fax (928) 314-9529
ARIZONA WESTERN COLLEGE
Hold Harmless Agreement
To the fullest extent permitted by law, lessee or user shall defend, indemnify, and hold harmless Arizona Western College, its agents, officers, employees and volunteers from and against all claims, damages, losses, and expenses (including but not limited to attorney fees and court costs) arising from the acts, errors, mistakes, omissions, work or service of lessee, its agents, employees, volunteers by reason of liability imposed by law upon the owner for damage because of bodily injury, including death at any time resulting there from, or on account of damage on property sustained by any persons arising out of or in consequence of the activity performed by the user, whether or not such bodily injury and/or damage to property are due or claimed to be due to any negligence or acts, including violations or any duty imposed by a statute, ordinance or regulation of the user, the employees or agents of any of them, or any other person in the performance of this agreement.
The amount and type of insurance coverage requirements, if applicable, will in no way be construed as limited the scope of indemnification.
Name of Organization
Authorized Representative Signature
Date
Arizona Western College
Director of Risk Management
Date