UH Facilities Use Form

Is the facility being reserved by a Ulen-Hitterdal Public Schools organization?

If the facility is being used by an outside group, a usage/rental fee ($) must be paid.

Name of Organization

Person who is submitting this form:

Facility Information:

Facilities being requested for use:

If you selected "Other Classroom" please specify which one (s) in this box

Start Time (Format- HH:MM AM/PM)

End Time (Format- HH:MM AM/PM)

On Site Supervisor Information:

This individual is responsible for following all UH Policies and Guidelines and ensuring all participants do the same. This person assumes any and all liability including, but not limited to, the facility being damaged, theft or loss of any items or equipment within the facility, etc. They are also responsible for clean-up after the event, locking of the doors and turning off of any lights. Should a custodian be needed, an additional fee to cover the cost of the custodian will be added.

Supervisor First Name:

Supervisor Last Name:

Will a custodian need to be present during this event?

Yes No

A representative from Ulen-Hitterdal Public Schools will be contacting you to confirm your facilities request or if any other information is needed. Thank you.

Send a copy of the completed form to this email address :

* Indicates Required fields.

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