Confirmation of Event Scheduled at
Arkansas State University Mountain Home

(*) denotes required information.

* Room Requested:

* Name or type of event:

* Date(s) of event:

* Full Name:

* Phone/Fax:

* Email:

* Start/End Times:

Estimated number of participants:

Number of speakers:

Please list any special arrangements or equipment needed:




ASUMH is a state-supported institution and the use of all facilities must be consistent with the mission of ASUMH. The determination of appropriate use will be determined by the Vice Chancellor for Administrative Affairs.

  1. Tobacco use of any kind is not allowed anywhere on campus.

  2. Food is only allowed in the Hurd Student Center, Bruce Family Room, and Gaston Lobby.

  3. A campus map is available at our website:

  4. All events must be open to the public.

  5. No fees may be collected by non-university organizations.

  6. No money of any kind may be raised for organizations not affiliated with ASUMH.

  7. No advertising, distribution of promotional items, solicitation, or any other forms of marketing by non-university groups.

  8. Non-university groups will be charged a maintenance fee, due prior to the meeting date.

  9. ASUMH reserves the right to cancel or reschedule any events.


*    I have reviewed the information I provided listed above and certify it to be correct. Also, I have read, and agree to abide by the rules and regulations set forth by Arkansas State University Mountain Home.

Signature of event representative: ______________________________________________ Date: 

Print a copy of this page before submitting and return a signed copy to:

Arkansas State University Mountain Home
Attn: Katy Page
1600 South College Street
Mountain Home, AR 72653
Fax: 870-508-6286