Bernie Appearance Request

Bernie Appearance Request
Please submit your appearance request at least two business weeks prior to your event. All reservations will be reviewed on a first come, first basis and will be fulfilled based on performer availability. We reserve the right to refuse requests that do not meet the two week minimum.

Please submit this form, or send the information listed below to:

Alvernia University
Attention: Office of Student Activities
400 Saint Bernardine Street
Reading, PA 19607

Contact information

Office of Student Activities
610-796-8408 or student.activites@alvernia.edu
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Contact person on day of performance:*
Contact Person's Cell Number: *
Please enter a valid phone number.
Date Request Made:*

MonthDayYear
Date
Purpose of Appearance:*
Date of Performance: *

MonthDayYear
Date
Time Performer is to Arrive: *

Hour Minutes

AM/PM Option
Time of Performance: *

Hour Minutes

AM/PM Option
If the performance is on campus, please list the building below.*

Building on Campus

Street Address Line 2

CityState / Province

Postal / Zip Code
Location of Performance if OFF Campus *

Street Address

Building Name

CityState / Province

Postal / Zip Code
Location Performer can prepare/take breaks: *
Special Requests (hand out balloons, etc) *
Should be Empty: