Summer 2017 Term 2 - ECESS Locker Rental Form
This locker rental form applies for this Summer 2017 Term 2 session: July 4, 2017 - August 19, 2017 and will cost $10.
You must empty out your locker by the end of day on August 19, 2017.

Note: successful locker rental is conditional based upon availability of lockers and successful payment of invoice. Filling out this form alone is not sufficient to rent a locker!

You will only receive a locker number once the payment has been made.
Payment method will be by credit or debit via a Square invoice which we will send you.

You should additionally receive a confirmation email after filling out this form. If you do not, please let us know by emailing This confirmation email does not guarantee a locker, it does confirm that we have received your form and will process forms in order of form submission.

Email address *
Name *
First Name, Last Name
Your answer
Phone number *
e.g. 012-345-6789
Your answer
Desired locker location (optional)
You can enter a desired locker number here. If you don't know what lockers are located where, just indicate the general area you would like the locker, you could write for e.g. machine shop, or 1st floor lab, etc.
Your answer
Have you read the Locker Rental Agreement? *
Please read the agreement here (you do not need to fill it out, filling this form does the same thing):
How would you like to pay? *
At this time we are only offering credit or debit payments via Square. Please select that option.
A copy of your responses will be emailed to the address you provided.
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