Space Rental Payment
Name
*
First Name
Last Name
Email
*
Program Title
*
Event Start Date
*
Event End Date
*
Event Frequency
*
One-time Event
Daily
Weekly
Bi-Weekly
Monthly
Bi-Monthly
Yearly
Other
How long did you use the space? (e.g. 3 hours once, 2 hours/week for 10 weeks, 1 hour/month for 12 months, etc.)
*
Which space did you rent? (check all that apply)
*
Small Room ($20/hour)
Conference Room ($30/hour)
Main Hall ($40/hour)
Total Number of hours (Please calculate the total number of hours for which you used the space)
*
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USD
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
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2043
2044
2045
Expiration Year
Total
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