Penn State Harrisburg

Facility Request Form

Submission of the following form is a formal request to use the facilities and/or services of Penn State Harrisburg. Note that all requests are subject to approval; submission of the request form should not be considered an approval for use of facilities and/or services.

Note:

  • Most facilities and services have associated fees. An estimated fee schedule will be provided for requests that meet initial approval.
  • Programs involving minors (under the age of 18) are governed by Penn State Policy AD-39.
  • The use of the Penn State name is limited to the location of approved events, as per Policy AD-03.

Please complete the following form in its entirety; incomplete forms will not be processed.

Contact Information
(e.g. xxx-xxx-xxxx)
Event Information

:
:
Participant Makeup
Please indicate the projected number of participants for this event, broken out by number of minors (younger than 18 years old) and legal adults (18 or older).

Reminder: Programs involving minors are governed by Penn State Policy AD-39.

Have you utilized our space for this event in the past?

Services Requested