Kulkarni and EAB Black Box Theatre Facility Request Form

This form is to be used by Penn State Harrisburg students, advisors, faculty and staff to request use of the Kulkarni Theatre or the Black Box Theatre in the EAB. Please complete the form before calling to request the use of the above facilities. Provide as much information as possible on this form.

After your request is submitted, the Arts Administrator will call or email you to discuss the request. If the event is approved, you will receive a fully signed request form via email or campus mail.

Note: Only a fully signed form indicates a confirmed reservation.

Contact Information (Event Organizer)
Charges for additional technical staff/equipment rental may apply
Director (administrative units), School Director (academic units) or advisor (student clubs)
Please check for accuracy; a copy of this request will automatically be sent to this address.
Event Information
Please use specific language, for example: Co-curricular program, speaker presentation, cultural program, lecture, meeting, panel discussion, performance event, etc.
If the requested stage setup is available, please upload it now. Refer to the Stage Diagram (PDF).
Files must be less than 5 MB.
Allowed file types: gif jpg jpeg png.
Kulkarni Theatre inventory: 30 blue plastic chairs. PPO work order needed for delivery and pick-up of additional chairs beyond 30.
# of chairs
# of tables

Technical Charges/Fees

Due to staffing issues and additional needs, fees may be charged to your provided budget for events that involve performance elements and extended hours.  During a meeting/consultation, fees will be determined for technical staff and/or equipment rentals.  An IDCC form will be submitted for charges to your budget.  If any equipment is damaged or clean up is needed beyond the usual cleaning, your budget would be charged as well.

Theatre Service Fee:  $30.00/hour with a 4-hour minimum per day.

Please Note:
  • All catering needs are handling independently by the requestor. Please contact Housing & Food Services to arrange for food delivery and pick-up/clean-up after your event.
  • All video and electronic files should be emailed to Matt Mitra, mrm454 at least 3 days prior to the event.
I certify that the responses provided on this request form are true and complete to the best of my knowledge.