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FOR OFFICE USE ONLY DATE RECEIVED TOTAL RENTAL FEE PAID RECEIPT NO. PAYMENT TYPE EXPIRATION DATE ACCEPTED BY CASH CHECK LOCKER PLEASE DENOTE M FOR MEN S LOCKER ROOM AND W FOR WOMEN S LOCKER ROOM. LOCKER RENTAL CONTRACT PLEASE PRINT Date Last Name First Name Home Phone MI Email UIN Please select the box that applies Student Faculty/Staff Faculty/Spouse Staff Retiree Graduate Graduate Spouse TYPE OF RENTAL Half Locker for Fall or Spring Semester 30 Full Locker for Fall or Spring Semester...
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