Event Reservation Request

Event Name:
Name of Authorized Representative:
Mailing/Billing Address:
City:
State:
Zip Code:
Daytime Telephone:
Evening Telephone
or Cell:
Fax Number:
E-mail Address:
Date(s) of the Event:
Expected Attendance:
  

Facilities/Services Requested

Conference/Meeting Room(s)? YES

  Number Attending:

NO
Lodging? YES Number of Persons:  Number of Nights:
NO
Dining/Catering? YES

 Number attending:

NO

  
Confirmations

The submission of this form does not confirm your reservation. Reservation requests must be submitted at least three weeks prior to the date of the event. An agreement including the cost for all requested functions, lodging, culinary offerings, technology support, etc., will be developed by the Event Coordinator and presented to the authorized representative at least ten (10) business days prior to the event.

Click the SUBMIT button below and your reservation form will be emailed to Lake Point Conference Center. If you prefer to mail or fax the form, use your browser's PRINT function to print this completed form and mail or fax it to the address noted below:

Lake Point Conference Center at Arkansas Tech University
171 Lake Point Lane
Russellville, AR 72802
PHONE: 479-356-6240
FAX: 479-356-3239