formerly University of Missouri-Rolla
Student Activity Permit

Reservation requests are handled on a first come, first served basis and need to be made at least 48 hours (2 business days) in advance. The Student Life management staff reserves the right to make room assignments based on space availability, type of request, and number of participants. If you have any questions, please email reserve@mst.edu.

* denotes required field

Event Information

Student Organization*:
President's Name*:
Event Title:
Event Type*:
Hold the <Ctrl> key to select multiple options.
If other, please specify:

Contact Information

Organization Advisor*:
Name*
Your Information*:
Contact information for the person making the request.
Name*
Phone*
Email*
Event Contact:
Contact information for the person in charge of the event if different from the above contact.
Name
Phone
Email

Access Information

Date(s) of Event*:
mm/dd/yy format		 Click here to pick dates
Facility Access Time: to
Event Time*: to

Facility Needs

Desired Facility*:
Hold the <Ctrl> key to select multiple options.



If other, classrooom, or outdoors,
specify a specific location:
Number of Participants*:
Number of Rooms*:
Specify the number of rooms desired for each type of room setup needed.

Click here to see the setup options.
Theater Classroom
Conference Banquet
Empty U-Shape
Other
If other, please specify setup desired:
Head Table Specify number of settings needed at the head table:

Equipment/Supplies

Audio/Visual Equipment:
Specify the number of each piece of equipment needed.
Overhead projector w/screen Multimedia projector w/screen
Screen TV/VCR
TV/DVD Microphones
Supplies:
Specify the number of each supply needed.
Easel Dry-erase board
Podium Stage
Dance floor Carousel Projector
Piano Blackboard
Table-top Podium Floor Podium
Flag(s) US
MO
Missouri S&T 		Other
If other, please specify supply desired:

Event Setup

Food Service:
Only campus-catered meals are permitted in the Havener Center. To order catering, visit Chartwell's website.
Options:
Admission Charged? No Yes
Alcohol Served? No Yes
Using Decorations? No Yes

Comments

Special Instructions:
Type your special instructions or comments here.

* denotes required field