EQUIPMENT RENTAL FORM
(FOR EQUIPMENT USED OUTSIDE OF JOHNSON CENTER AND STUDENT UNIONS)
Student Centers
4400 University Drive, MSN 5A3, Fairfax, VA 22030-4444
Johnson Center - Room 324 - Phone 703-993-2921 - Fax 703-993-2919
Date ___________________
REQUESTOR INFORMATION
Organization/Department __________________________________________________
Contact Person ___________________________________________________________
Address _________________________________________________________________
Phone __________________________________Fax _____________________________
Email _________________________________ Index Number ____________________
ITEM
QUANTITY
COST PER UNIT/PER DAY
TOTAL
TV/DVD/VCR
$40.00
Slide Projector/Overhead
$28.00
Table Skirt
$5.00
Floor Podium
$55.00
Amplified Podium
$96.00
Pipe & Drape (6ft panel)
$13.00
Whiteboard/ Tripod Easel
$5.00
Chair
$5.00
Table
$10.00
Staging (per section)
$25.00
Stanchions (per section)
$10.00
"Rush" Fee
$25.00
Return Check Fee
$25.00
Totals
LOAN INFORMATION
Pick up time/date _________________
Return time/date _________________
Location of Event _________________
________________________________
FORM OF PAYMENT
Cash
Check
Journal Voucher
Check Request
Make checks payable to
George Mason University
RENTAL AGREEMENT
Equipment must be picked up by requesting organization and returned by requesting organization.
Request must be made at least 3 days prior to pick-up date. Other requests will be charged a rush fee of $25.
Equipment not returned on time will accrue an additional day rental charge plus a $ 25 per day late return fee.
Requesting Organizations will be held responsible for all damaged and missing equipment.
This form also serves as an invoice. Payments should be made according to informatio