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8f1d1bf7-09bf-4d1c-9b65-6bb9fc418553
Textbox
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Name:
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*
selection is required
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aa071ee3-8941-43c5-92af-0503a3f5b0c3
Textbox
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Address:
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*
selection is required
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ac775056-a2cb-45ae-8115-b214964d6840
Textbox
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Phone Number 1:
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*
selection is required
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ba67ffb8-5896-4852-87f8-c7131fb0765c
Textbox
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Phone Number 2:
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f6898b29-0f0f-4ef6-a2c5-39fdc1ecf328
Textbox
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Email:
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*
selection is required
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f924c81a-ed2f-4962-b69e-7206882b1337
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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16938638-2078-41dc-bc8c-043419cfc5bd
Textbox
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Reservation Date:
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*
selection is required
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536e5504-48ba-47d7-ba87-5b1389243381
Textbox
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Start Time:
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*
selection is required
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2fcb633b-5409-4fc6-b7db-dc090c7175c4
Dropdown List
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Start Time AM or PM:
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*
selection is required
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0be4beb5-7f24-4a69-b254-d0c5de1a454d
Textbox
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End Time:
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*
selection is required
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3fee4f95-fcca-487f-b673-bc49ef146016
Dropdown List
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End Time AM or PM:
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*
selection is required
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6cc7415f-c6b0-46cf-8fee-45c2e56c5b5d
Label
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Rental rates are as follows
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35a9e89d-461e-4547-973f-0775a696c7af
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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f7b07d32-b6ae-46ee-86bc-47725f518094
Label
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For-profit costs: $15 per hour
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1501fb93-6d09-4a58-a953-ca34613d5c36
Inline Text
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1ee25f53-f696-4ffb-9d9d-3a4118ed572f
Dropdown List
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Identify if the event is not for-profit or for-profit
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*
selection is required
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f3c110be-7a11-4754-bd8b-6b69bab753e5
Dropdown List
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Event Type:
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*
selection is required
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6aaba147-4709-45ed-b988-a4cfff52e2ec
Textbox
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Event Details:
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*
selection is required
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5f26a4f0-e764-4532-9d70-fb19539146b5
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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3b5411db-eddd-4ee6-ba5f-7c547690b649
Electronic Signature
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Signature:
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2e76aa85-83de-4b2f-b7ef-fd424202c1a7
Textbox
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Today's Date
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*
selection is required
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b31dc9bb-2577-4176-a3f7-5d11b1ffc703
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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