|
27d425d7-ea1d-49b2-aab6-eb2ee5f677c0
Textbox
|
Name:
|
*
selection is required
|
|
652c4782-f601-45b6-8e1e-001896f482c7
Textbox
|
Address:
|
*
selection is required
|
|
2b43d9c3-50c6-4598-95fd-2cdf080e2ef7
Textbox
|
Phone Number 1:
|
*
selection is required
|
|
d719a3c6-488a-4690-ab9d-f1d6a3bc37f2
Textbox
|
Phone Number 2:
|
|
|
3364c3ab-ee4f-4812-8a2e-aa3f2838e49d
Textbox
|
Email:
|
*
selection is required
|
|
e5b0ac34-0c6d-471c-bb0f-fdc67a17ca2c
Label
|
The conference room closes promptly at 10:00 PM. Arriving prior to or staying after your reserved time is prohibited.
|
|
|
63e83efa-cc9e-41aa-a1d2-d35b975a1eec
Textbox
|
Reservation Date:
|
*
selection is required
|
|
68dc31eb-7680-4bdd-ae62-bbcc003b8992
Textbox
|
Start Time:
|
*
selection is required
|
|
50629a56-0b83-4cc2-9e56-ce8a696d61b1
Dropdown List
|
Start Time AM or PM:
|
*
selection is required
|
|
da04159c-52f6-4d0a-ac97-6de590ffbd75
Textbox
|
End Time:
|
*
selection is required
|
|
9b0f315a-b089-4695-93f8-4defd365da0d
Dropdown List
|
End Time AM or PM:
|
*
selection is required
|
|
73a7652a-5d8d-4285-99b8-b7ba144e71fc
Label
|
Rental rates are as follows
|
|
|
28cd5c64-c4ed-4557-be2e-3dbaaa69fc06
Label
|
Not for-profit costs: 1 hour = $5, 2 hours = $10, 3 hours = $20, 4 hours = $40, each additional hour over 4 hours = $15
|
|
|
22be71e5-c660-46f4-bbf9-292936a340b0
Label
|
For-profit costs: $15 per hour
|
|
|
bc457961-4696-41e8-95c6-b1cbcc583b8d
Inline Text
|
|
|
|
c9bdaa68-55ec-47cf-9775-b8b6bb51b4c3
Dropdown List
|
Identify if the event is not for-profit or for-profit
|
*
selection is required
|
|
20167e85-178a-462d-b3b2-b7541231b0d9
Dropdown List
|
Event Type:
|
*
selection is required
|
|
254759a0-c61a-42e8-a35b-d507dd9b130f
Textbox
|
Event Details:
|
*
selection is required
|
|
8a5e9a79-4589-4416-a7c9-5fd1beeef59a
Inline Text
|
Acknowledgement that you have read and accept the policies for use of the room (including financial responsibility for any additional charges/fines which may result from the event - see the Conference Room Policies for possible fines)
|
|
|
cf6cb374-cf58-4c94-addd-8742f09bc18f
Electronic Signature
|
Signature:
|
|
|
09157b5e-3a68-4a67-b149-f6ff89de3ffc
Textbox
|
Today's Date
|
*
selection is required
|
|
64175872-3465-4b82-bd72-1cf20a3e2627
Inline Text
|
Once you submit this request, please review your completed copy for additional information regarding the review process and payment instructions.
|
|
| | |
|