GoldPLUS Card Reader Contract

Organization Name:
Account Number:
Contact Person:
Position:
Phone: Your Email:
Event Title:
Event Date:
DATE(S) CARD READER IS NEEDED:
Location: ULRICH Student Center UC - University Center LA - Lamberton Hall
Start Time:   End Time:
Description of Sale:
Cost (per item):
Additional Comments:

Click here to read the GoldPLUS Card Reader rental information.

Disclaimer: I have read the GoldPLUS Card Reader Rental Information and agree to all terms and conditions in renting the GoldPLUS Card Reader. Also myself, along with my organization, , agree to be responsible for the return of the Card Reader and for any and all financial transactions that are incurred.
AGREE: Yes/No:

If you haven't reserved your table space, fill out the Table Request Form to do so.