Additional Approvals Required (Yes or No):
Issued by: Katie Bonner, Student Affairs (215)898-6533 DATE: 12/13/2017
Laura Carney, Perelman Quadrangle (215)898-5552
THE EVENT DIRECTOR IS RESPONSIBLE FOR PRESENTING ONE COPY OF THIS FORM TO THE DEPARTMENT OF PUBLIC SAFETY, SECURITY PERSONNEL OR UNIVERSITY OF PENNSYLVANIA STAFF MEMEBERS UPON REQUEST. GROUPS ASSUME ALL COSTS RELATED TO THE USE OF THER AREAS INDICATED AND FURTHER ACCEPTS FULL FINANCIAL RESPONSIBILITY FOR ANY DAMAGES WHICH MAY RESULT FROM THE GROUP'S USE. GROUPS MAY ONLY USE THE FACILITIES PERMITTED FOR THEIR USE AS INDICATED ABOVE.
PLEASE NOTE: CANCELLATIONS MADE WITHOUT APPROPRIATE 24 HOUR NOTICE, THE INDIVIDUAL OR GROUP WILL BE BILLED FOR SERVICES
Special Instructions or Needs:
I have read and agree to abide by all University of Pennsylvania polices.
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