Memory Booth Check Out Form
Please complete this form in it's entirety within two weeks of when you intend to use the memory booth. Once you submit it, you can expect to receive a call or email within two business days with further instructions. Thank you for your interest in the HMFM Memory Booth! You are helping us keep history alive.
Name:
Phone Number:
*
Email address:
*
Organization requesting use of booth:
*
Head of Organization:
*
Event/Program Date:
*
Pick Up Date:
-
Month
-
Day
Year
Date
Return Date:
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Month
-
Day
Year
Date
Reason for requesting the Memory Booth:
Location where equipment will be used:
*
Where/how did you hear about the Memory Booth?
Other comments?
Would you like to keep updated on Museum happenings by receiving our monthly Newsflash e-mail?
Yes
No
Submit
Should be Empty: