SD Mines Wellness Center Locker Clean Out
Please complete this form if you would to pick up your locker items prior to the end of the semester.
Email address *
First and Last Name *
Your answer
ID Number *
Your answer
Classification *
Mines Email *
Your answer
Phone Number *
Your answer
Are you coordinating with Residence Life to move out your belongings from on-campus housing? *
Locker Room Location *
Locker Number *
Your answer
If you are using a personal lock, what is the combination? *
Your answer
Do you have a preferred date and time that you would like to come and pick up your items? (Note, we cannot guarantee this time, but will do our best to accommodate)
Your answer
Please initial to acknowledge that you understand that SDSMT may need to cut your lock to retrieve your items. *
Your answer
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