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Locker Request

The document is a locker use agreement form for the Department of Music at Texas Woman's University. It requires the student to provide their contact information and agree to five terms, including relinquishing the locker at the end of each semester, being responsible for any repair or replacement costs for damaged lockers or locks, being responsible for the locker and lock being in working order, and paying any fees by the end of the semester. It also lists the instrument and locker rental fees charged by the department each semester.

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Khira Young
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32 views2 pages

Locker Request

The document is a locker use agreement form for the Department of Music at Texas Woman's University. It requires the student to provide their contact information and agree to five terms, including relinquishing the locker at the end of each semester, being responsible for any repair or replacement costs for damaged lockers or locks, being responsible for the locker and lock being in working order, and paying any fees by the end of the semester. It also lists the instrument and locker rental fees charged by the department each semester.

Uploaded by

Khira Young
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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TEXAS WOMAN'S UNIVERSITY - DEPARTMENT OF MUSIC

LOCKER USE AGREEMENT

LOCKER # __________ COMBINATION # ____________________

NAME ______________________________________ STUDENT I.D. # __________________

CELL PHONE # _________________________ WORK PHONE # _______________________

E-MAIL ADDRESS ________________________________@twu.edu

STREET ADDRESS _____________________________________________________________

CITY _____________________________ STATE ___________ ZIP CODE ________________

I ________________________________________ (hereinafter, TWU student) agree to the


(print name)
following terms and conditions by accepting the use of an instrument locker from the TWU
Department of Music for storing of a personal instrument.

PLEASE READ CAREFULLY


1. The student agrees to relinquish use of the locker & lock immediately following the end of each semester.
2. The student agrees that any locker &/or lock not returned to the director/instructor immediately following
the semester, or returned in a damaged or deficient state, will be replaced and/or repaired by the TWU
Department of Music, and the student will be charged the replacement or repair cost of the locker &/or
lock.
3. The student agrees that if any charges owed by the student are not paid prior to the last day of the
applicable semester, the student's grades will be held by the instructor until all charges are paid in full.
4. The student agrees that the locker & lock will remain in good working order at all times.
5. The student agrees to take full responsibility for the locker & lock and is ultimately responsible for the care
and maintenance of the locker during the check-out period.

___________________________________________________ ___________________
(Signature of Student) (date)

___________________________________________________ ___________________
(TWU Instrument Inventory Manager) (date)
TEXAS WOMAN'S UNIVERSITY - DEPARTMENT OF MUSIC
INSTRUMENT/LOCKER RENTAL FEES

Type of Rental Fee/semester

Instrumental Methods Class $20.00


(Woodwind Techniques - MU 3041)
(Brass Techniques - MU 3001)
(Percussion Techniques - MU 3011)
(String Techniques - MU 3031)

Instrumental Ensemble and/or Applied Lessons $30.00


(Applied Lessons - varies)
(Wind Symphony - MU 3541/5541)
(University Band - MU 3611)
(Jazz Ensemble - MU 3571/5571)
(Chamber Music - MU 3581/5581)
(Chamber Orchestra - MU 3641/5641)

Personal Use $40.00

* All instrument rentals come with complimentary locker rental

Locker Rental $20.00

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