ORDER FORM. SINGLE SEMESTER. FALL 2010
| First Name, MI* | |
| Last Name* | |
| Dorm & Room #(delivery address)* | |
| Your home (not the school) Address* | |
| Your home city & state* | |
| Arrival Date* | |
| Zip/Postal Code (HOME)* | |
| Contact Phone* | |
| EMAIL Address ( SEE BELOW)** |
**THE E MAIL ADDRESS THAT YOU PROVIDE ABOVE WILL BE USED FOR ALL CORRESPONDENCE WITH YOU THROUGHOUT THE SCHOOL YEAR. IF YOU CHANGE YOUR MAIN E MAIL ADDRESS, PLEASE CONTACT US SO THAT YOU WILL NOT MISS INFORMATION REGARDING THE COLLECTION AT SEMESTER END.
2) PLEASE CHECK THE ITEMS YOU WISH TO RENT
(ALL PRICES ARE PER SINGLE SEMESTER)
| DESCRIPTION | ||
| MICR0WAVE-FRIDGE-FREEZER
COMBO.................$108.75 +
$6.25 TAX=$115.00
|
||
| 3.0 CU.FT.
FRIDGE/FREEZER COMBO....$89 +$5.34 TAX=$94.34
|
||
| 20" COLOR TELEVISION...................$74.70 + $4.30 TAX= $79.00 | ||
| * | REFUNDABLE DEPOSIT REQUIRED FOR EACH ORDER............................ ...........................).........................$10.00 |
ORDER TOTAL :
PLEASE TELL US HOW YOU ORIGINALLY HEARD ABOUT OUR COMPANY
A POSTER/FLYER LOCATED IN MY DORM
INTERNET SEARCH
INFORMATION DISTRIBUTED AT ORIENTATION
OTHER STUDENTS
I AM A PREVIOUS PREVIOUS CUSTOMER
3) PAYMENT
PLEASE CHARGE THIS TO MY CREDIT CARD. . PRESS THE SUBMIT BUTTON TO ORDER ELECTRONICALLY OR PRINT AND MAIL THIS FORM TO CAMPUS RENTALS, 502 E FRANKLIN AVE., SILVER SPRING, MD 20901.
ONCE WE PROCESS YOUR ORDER, WE WILL SEND A CONFIRMATION (USUALLY WITHIN 24 HOURS) TO THE EMAIL ADDRESS YOU HAVE GIVEN WITH YOUR SPECIFIC DELIVERY INFORMATION
VISA OR MASTERCARD
| CREDIT CARD NUMBER | |
| EXPIRATION DATE |
 |
______________________________________________________________________
I HAVE READ AND AGREE TO THE TERMS OF THE RENTAL AGREEMENT STATED HEREIN. (CHECK BOX)
IF YOU EXPERIENCE ANY DIFFICULTY IN SUBMITTING YOUR ORDER, PLEASE CONTACT US AT THE E MAIL ADDRESS BELOW. THANK YOU.
HAVE QUESTIONS ?.....CONTACT US: