Civic House Room Reservation Form

On-line Room Request Form

You must read and agree to the following rules and regulations for Civic House room use before filling out an on-line request.
Please note that it can take up to one week to process room requests. If your group is having an upcoming meeting or event please plan in advance and make your requests early.

  • Facilities will only be used for nonprofit purposes.
  • Organization agrees that it will be financially responsible for all damage or all harm to facilities; responsible for returning furniture to proper place after use; and if food is used or prepared, clean kitchen, recycle as appropriate, and empty trash in dumpster out back.
  • Organization must comply with all applicable CIVIC HOUSE policies and regulations.
  • Civic House is a NON-SMOKING facility.
  • No alcoholic beverages can be served or consumed in or on the premises.
  • If rules or regulations are violated, CIVIC HOUSE reserves the right not to accept an organization's request for room reservations.
  • Cancellations should be given 24-hour notice before the day of the event.
You will hear from someone via email within one week of your request.  A confirmation is necessary and will be conveyed to you via email.

I have read and agree to the rules and regulations set forth by Civic House concerning room use. *
Contact Information
Name of Organization
Contact Person
Second Contact
Campus Address
StatusStudentStaffFaculty
Phone Number
Email Address
Room Request
First Choice
Second Choice
Event Information
Type of EventOne-timeWeeklyMonthly
Date of Event (Multiple dates format: mm/dd/yy, mm/dd/yy)
Start Time
End Time
Description of Event
Expected Attendance
Special Needs (i.e. video, easel, computer hook-up)
Additional Comments
Code:  56897 Re-type Code: (Required)




University of Pennsylvania Civic House 3914 Locust Walk/6152 215-898-4831 civic@dolphin.upenn.edu