Space Rental Payment
Name
*
First Name
Last Name
Email
*
Program Title
*
Rental Date
*
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Month
-
Day
Year
Date
Which space did you rent?
*
Small Room ($20/hour)
Conference Room ($30/hour)
Main Hall ($40/hour)
Number of hours
*
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USD
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Total
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