Locker Rental Agreement

Please complete this form to request a School of Music instrument or coat locker.

Please note: a $20.00 charge will be applied to your U-bill for each locker checked out.

Student must sign this form electronically before a locker will be issued.

Locker Rental Agreement

First Name

Last Name

UNI ID #

Address

City

State

ZIP Code

Phone Number

Email Address

Which Building Would You Like a Locker In?

What Type of Locker Would You Like?

Please list the instrument(s) you play, and what you will need to store in your locker

At least one instrument must be noted in order to be issued an instrument locker. If you plan to store multiple instruments/items, every effort will be made to accommodate your request.

Electronic Signature

By typing my name here I agree to the policy outlined above.