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