Rental Equipmemt
ISLAMIC CENTER OF BATON ROUGE
ICBR EQUIPMENT RENTAL FORM
Date of Rental
-
Month
-
Day
Year
Date
Date of Return
-
Month
-
Day
Year
Date
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I Acknowledge that the
Late Fees are $3.50 per Chair and $10.00 Per Table Per Additional Day
For Office Use Only
Equipmemt Received By
Received Date
-
Month
-
Day
Year
Date
Equipmemt Return By
Return Date
-
Month
-
Day
Year
Date
THE EQUIPMENT FEES ARE AS FOLLOWS
My Products
prev
next
( X )
$3.50 PER CHAIR
PER CHAIR ADDITIONAL DAY
$3.50
$
3.50
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
$10.00 PER TABLE:
PER TABLE PER ADDITIONAL DAY
$10.00
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
Credit Card
Submit
Should be Empty: