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Room Reservation
First Name:
*
Last Name:
*
Email:
*
Phone:
*
Fax:
Organization/Department:
*
Organization/Event Type:
*
LGBT Student Group
On Campus Student Group
Other Penn Offices
Penn Affiliated
Private Event
Non-Penn Affiliated
Penn email (required if Penn-affiliated in any way):
Person in charge of event:
*
Mobile number of person on-site for event:
*
Email of person in charge/on-site for event:
*
Event Information and Room Request
Event Title:
*
Event Description:
Event Type:
Banquet
Class
Conference
Lecture
Meeting
Party
Reception
Other
Event Date (MM/DD/YYYY):
*
Event Start/End Time:
Start Time:
*
12:00
12:30
1:00
1:30
2:00
2:30
3:00
3:30
4:00
4:30
5:00
5:30
6:00
6:30
7:00
7:30
8:00
8:30
9:00
9:30
10:00
10:30
11:00
11:30
AM/PM:
*
AM
PM
End Time:
*
12:00
12:30
1:00
1:30
2:00
2:30
3:00
3:30
4:00
4:30
5:00
5:30
6:00
6:30
7:00
7:30
8:00
8:30
9:00
9:30
10:00
10:30
11:00
11:30
AM/PM:
*
AM
PM
Event Pre-Access/Post-Access Time:
Pre-Access:
*
12:00
12:30
1:00
1:30
2:00
2:30
3:00
3:30
4:00
4:30
5:00
5:30
6:00
6:30
7:00
7:30
8:00
8:30
9:00
9:30
10:00
10:30
11:00
11:30
AM/PM:
*
AM
PM
Post-Access:
*
12:00
12:30
1:00
1:30
2:00
2:30
3:00
3:30
4:00
4:30
5:00
5:30
6:00
6:30
7:00
7:30
8:00
8:30
9:00
9:30
10:00
10:30
11:00
11:30
AM/PM:
*
AM
PM
Approximate Number of Attendees:
*
Space (1st Choice):
Goodhand Room
Kitchen
Lounge
Reception Area
Patio
Garden
Courtyard
Reading Room
Conference Room
Cyber Center
Any Available
Space (2nd Choice):
Goodhand Room
Kitchen
Lounge
Reception Area
Patio
Garden
Courtyard
Reading Room
Conference Room
Cyber Center
Any Available
Space Option:
Alternate
Additional
Space (3rd Choice):
Goodhand Room
Kitchen
Lounge
Reception Area
Patio
Garden
Courtyard
Reading Room
Conference Room
Cyber Center
Any Available
Space Option:
Alternate
Additional
Space (4th Choice):
Goodhand Room
Kitchen
Lounge
Reception Area
Patio
Garden
Courtyard
Reading Room
Conference Room
Cyber Center
Any Available
Space Option:
Alternate
Additional
Is this a recurring event?:
Yes
No
How often will the event recur?:
Daily
Weekly
Biweekly
Monthly on a Given Date
On what day(s) will the event recur (select all that apply):
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Other
If other, please specify:
Recurring Event Start Date (mm/dd/yyyy):
Recurring Event End Date (mm/dd/yyyy):
Any Additional Details about this Event:
Billing Information
Student groups are not billed for rooms and chairs during
hours of operation
. Other charges for equipment may apply and must be paid in advance. All other entities will be charged for use of space, including University of Pennsylvania staff and faculty.
All charges must be paid one week in advance for University affiliates, two weeks in advance for non-university affiliated individuals and organizations. Some events may require a deposit.
Note: Credit Cards NOT accepted
Method of Payment:
Cash
Money Order
Check
Journal Transfer
Budget Code:
Food and Beverages
There are no restrictions on catering , but food and beverages are not permitted in the Reading Room. You are to be responsible for your own clean-up and trash removal.
Will Food/Beverages be Present/Served?:
Yes
No
Food/Beverages will be:
Provided by the organizers
Provided by a caterer
Alcohol
Will Alcoholic Beverages be Present/Served:
Provided by the organizers
Provided by a caterer
No
Clients hosting events with alcohol have additional responsibilities.
The federal and state law prohibits the sale, directly or indirectly, of alcohol unless by a licensed vendor.
All undergraduate students and student organizations will be required to discuss and register the event with Office of Alcohol Policy Initiatives at 215- 573-3525.
No oversized or common source containers of any sort [including but not limited to kegs, punchbowls, beer balls, party balls] are permitted at any undergraduate on-campus party.
Checking the following indicates you have read, understand and agree to abide by the
University of Pennsylvania Alcohol Policy Initiatives
:
I Agree
Audio Visual Equipment Request - Must be reserved in advance of event
Will Audio/Visual or other Equipment be Required (additional fees may apply):
Yes
No
Please Check All that Apply
Please Check All A/V Equipment Required:
Digital Projector & Screen
Portable Amp & Speakers
Table Top Microphone
Podium (includes microphone and speaker)
Multimedia System - In Goodhand Room: (Includes 60" flat screen TV monitor connected to a PC and Xbox 360 game system. It is also capable of playing radio / CD / DVD / Blu-ray Disc)
Wii Gaming System - In Lounge
Other Equipment Request
Please check all that apply and specify quantities below:
Additional chairs
60" dia. round folding tables
30" x 72" rectangular folding tables
Whiteboard / Easel
For Equipment Required Please Specify Quantities:
The Multimedia System is included in the cost of the Goodhand Room rental fee.
Event Advertising
Would you like us to advertise your event on our public website calendar/newsletter:
Yes
No
Description for Advertisement:
Rules and Obligations
Please review the
Carriage House Facility Reservation Policy
for complete rules and regulations regarding facility usage.
Completing this form does not create a reservation for, nor does it constitute the Center's approval or confirmation of requested event services until all portions of this form have been completed, and written confirmation has been received from the reservation coordinator.
Payment must be made in full by the due date invoiced, prior to the date of the event or your event will be cancelled and any deposits will not be refundable.
Organization is responsible for any damage to the facility incurred during your event.
Organization is are responsible for the returning the room to its original state.
Organization must remove trash bags containing food from the building and place them in the dumpster behind the building. The kitchen must be cleaned after use.
Organization must be prepared to leave the space at the end of your reserved time.
If special event services are deemed necessary and assigned by the Center, or if details of the event are altered by the Organization at any time, the Center has the right to reassign space or to cancel the original reservation.
If rules are violated, Center staff reserve the right not to accept an individual's or organization's future request for room reservations.
Organization must comply with all applicable Center and University policies, procedures, rules and regulations including, but not limited to, the
University policies
regarding the Use of Alcohol and Drugs, Non-Discrimination, Classroom Guidelines, Use of Facilities, Open Expression Guidelines, and Code of Student Conduct.
If you cancel your event, please notify the Center. If it is not canceled 48 hours or more prior to its proposed start time, you will be billed the full event amount.
Questions? Please call (215) 898-5044, or stop by 3907 Spruce St. during business hours.
Disclaimer
The LGBT Center is not a full service catering hall. Although we will be happy to assist you in any way we can, please speak to one of our staff members or visit the Center to insure our facilities will meet your needs. During your event one of our trained staff members will be here to answer questions.
Please check this box to indicate you have read and agree to all terms of the Carriage House Facility Reservation Policy:
*
I have read the Reservation Policy
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