MiniFridge with Microwave Rental Order Form
Thank you for your interest in renting a MiniFridge with Microwave. If you are a CUA student, your student account will be billed for the rental. If you are a non-CUA student, you may pay for the rental by credit card. The rates are as follows:

$99.99 per semester (CUA Students)
$125 per semester (non-CUA Students)

For additional pricing, terms and conditions, please see the Rental Agreement (https://goo.gl/41CWmB).

Email address
Full Name
Your answer
Student ID Number
Your answer
Building
Your answer
Room Number
Your answer
Phone Number
Your answer
Term(s)
Required
Do you accept the terms and conditions of the CUA MiniFridge with Microwave Rental Agreement (https://goo.gl/41CWmB)?
Required
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This form was created inside of The Catholic University of America. Report Abuse - Terms of Service - Additional Terms
Google Forms