PSC Conference Room and Collaboration Space Reservation Form
Email address *
Please tell us who you are and then provide some details about your event:
First Name *
Your answer
Last name *
Your answer
Phone Number *
Your answer
Status *
If you are submitting this request for someone else, please identify that person and provide contact information for that person as you listed above for yourself:
Your answer
What space do you need? *
Number of people attending: *
Your answer
Please provide a brief description of the event: *
Your answer
The reservation is for: *
Indicate the type of event are you requesting the space for: *
Provide Date(s) and Start Time and End Time: *
Example for a one time use: 7/17/2012 9am-11am / Example for a repeating use: 7/17-24-31/2012 11am-1pm
Your answer
Any other information or additional comments:
Your answer
• Before your first meeting we can lend you keys for the space if needed, just let us know.
• Remember to sign out of the PC before leaving and to lock any doors you may have unlocked if after 5pm.
• If you rearrange furniture please return it to its original position.
• If you are having an event with food please dispose of any food and beverage related waste in the appropriate receptacles (with lids) or in the hallway.

If you have any technology/equipment questions or concerns while using the room please contact us: Demography Library (215) 898-5375,, or stop in to room 403 ; Social Sciences Computing (215)898-6454,, or stop in to room 304.
A copy of your responses will be emailed to the address you provided.
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