Viterbo University - The University of Opportunity: Hope and Help

Locker Rental


First Name                         Last Name

    
Street Address

City                                     State           Zip Code
            
Telephone                      Email
        

Classification:                 
                        
                     
                     

Locker Info:

Men's       
Locker #  
Lock Serial # 

Rental Terms:
 

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

Amount Received 

 

User Agreement 


  signed and dated?

 

Rec Sports Staff Completing Form:
 

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