Use of Residence Form · Starter Portal

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An Official Pennsylvania Government Website

Use of Residence Form

The Governor's Mansion is a historic building that has housed Pennsylvania's Governors since 1968.

Required fields are marked with an asterisk.(*)

Please ensure your guests treat it as you would your own home. The Residence is more than an event/meeting venue. It is the home of the people of Pennsylvania and deserves the respect and care that is necessary to provide a place for future generations to make their own history.

Requestor Information

First Name

*

Middle Initial

*

Last Name

*

Title

*

Phone Type

Phone Number (###-###-####)

*

Event Information

Event is NOT confirmed until official notice from the Residence via email.

Name of Event

*

Event Coordinators

*

Type of Event

Explanation of Other

*

Estimated Guest Count

**

Event Purpose

*

Start Date

*

End Date

*

Start Time:

Hours

*

Minutes

*

AM / PM

End Time

Hour

*

Minutes

*

AM/PM

Outside Caterer

NoYes

Audio Visual Needs

NoYes

FINANCIAL/COST RESPONSIBILITY AUTHORIZATION

First Name

*

Middle Initial

*

Last Name

*

Title

*

Department/Organization

*

Street address

*

Address Line 2

*

City

*

State

Zip Code

*

Phone Type

Phone Number (###-###-####)

*

Alternate Phone Type

Alternate Phone Number (###-###-####)

*

Email Address

*

Does this event fall under the provisions of the Sunshine Law?

NoYes

Process Overview

1. Please review the Use of Residence Guidelines prior to the submission of this Use of Residence Form

2. Fill out all sections of the Use of Residence Form and submit to the Executive Residence no less than 8 weeks prior to the desired event date.

3. Please allow approximately two weeks processing time. After its review, Residence management will notify the designated contact of its determination.

4. If approved, instructions outlining the planning progression will be sent via email.

By checking the box I acknowledge the process overview..

Invoicing

More details about the Use of Residence

If the request for use is approved, the authorized representative of the organization will be expected to sign a Facility Use Contract and to pay a use fee based on the number of persons expected to attend the event (0 to 25 persons: $200.00; 26 to 99 persons: $300.00; 100 and above persons: $500.00). Please refer to the Use of Residence Guidelines referenced above for more detailed information.

By checking the box I acknowledge the Invoicing process.

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