Media Lab Room Reservation Form

PA Wilds Media Lab Space Request Form

To reserve a space at the PA Wilds Media Lab at 61 N. Fraley St., 2nd Floor, Kane, PA 16735, please complete the form below. This helps us to understand your needs and process your request promptly. Please note: submission of this request form does not guarantee use. Spaces are available on a first-come, first-served basis. Once your request is received, you will receive a response from the PA Wilds Center team within 24-48 business hours.
Organization / Business Name:
If not applicable, enter N/A.
Name

First NameLast Name
Phone:
E-mail:
example@example.com
Room Preference:
Reservation Type:
Requested Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearSelect the date that you want to reserve.
Proposed Start Time:
Proposed End Time:
Any Special Request?
Should be Empty:

PA Wilds Media Lab Space Request Form