Locker Rental

First Name                         Last Name
    
Street Address

City                                     State           Zip Code
            
Telephone                      Email
        

Classification:                 
Student                        
Employee                     
Alumni
Other                     

Locker Info:

Men's    Women's   
Locker #  
Lock Serial # 

Rental Terms: 

Fall 2013 (Aug 16 - Jan 15) $10.00
Spring 2014 (Jan 16 - May 15) $10.00
Summer 2013 (May 16 - Aug 15) $5.00
     
Payment Type:
Cash 
Check  Check #  

Amount Received 

Select one $5.00 $10.00 $15.00 $20.00 $25.00  

User Agreement 

 User Agreement signed and dated?

 

Rec Sports Staff Completing Form:
 

Almost complete! Select Submit, and then follow the directions on the response page!