This form must be fully completed and returned to the office of Student Housing prior to the first day of the
This form must be fully completed and returned to the office of Student Housing prior to the first day of the semester which housing has been arranged. RESIDENT NAME: ____________________________________________________ (Please Print) Last Middle First ADDRESS: ____________________________________________________________________________ Address City State Zip Code Telephone: ______________________________ email: __________________________________ Campus Residence: ______________________________________________________________________ ********************* TERMS AND CONDITIONS: This storage receipt is issued by the Student Housing Department without verification by us and in reliance on information furnished by the depositor Student Housing does not know whether any part of the goods in fact were received or conform to the description on this receipt. Student Housing Department disclaims all liability for non receipt or mis-description of goods/ materials. …
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This form must be fully completed and returned to the office of Student Housing prior to the first day of the semester which housing has been arranged. RESIDENT NAME: ____________________________________________________ (Please Print) Last Middle First ADDRESS: ____________________________________________________________________________ Address City State Zip Code Telephone: ______________________________ email: __________________________________ Campus Residence: ______________________________________________________________________ ********************* TERMS AND CONDITIONS: This storage receipt is issued by the Student Housing Department without verification by us and in reliance on information furnished by the depositor Student Housing does not know whether any part of the goods in fact were received or conform to the description on this receipt. Student Housing Department disclaims all liability for non receipt or mis-description of goods/ materials. The Office of Student Housing will not accept for storage, nor be liable for, any of the following: Documents, Currency, Money, Jewelry, Watches, Precious Stones, Art Work, Antiques, Furs or other articles of extraordinary value, not will we accept any perishable items, liquid, illegal substances or any hazardous materials or waste. ACCEPTANCE: I have read and understood and agree to be bound by the conditions of this document and further , that I have the authority to sign this on behalf of the owner of the goods/materials being stored. Name: _________________________________Signature: ________________________________________________ --------------------Office Use Only-------------------- No. Pieces: ______________ Cost: _________________ Date: ___________________ Location of items: _______________________________________________________________________ Dormitory Attic/Closet SUMMER STORAGE CONTRACT REVISED SPRING 2007 ________________________________________ Student Housing Representative