StarLab Reservation Form

Fax this form to Laura Chase (707) 664-3263

StarLab Stipulations

  1. You must be 18 or older to check out the StarLab.
  2. The StarLab must be reserved at least 5 days in advance.
  3. The StarLab requires a rental donation that helps us maintain and improve the equipment. The donation is $30 dollars / day or if reserved for 5 days or more $20 dollars / day.
  4. You are responsible for acquiring the StarLab from the person who has it before you.
  5. After you have used it you must be willing to store the StarLab in a safe place until it is checked out again. If you don't want to store the StarLab after using it you must make arrangements to return it to Laura Chase (laurac@universe.sonoma.edu or 707-664-3261) at Sonoma State University in Rohnert Park.

Check Out Information

First Name: _________________________________________

Last Name: _________________________________________

Title: ______________________________________________

Address 1: _________________________________________

Address 2: _________________________________________

City: ______________________________________________

State: _______Zip:___________________________________

Work Phone: (____) ____ - _______ ext. ______

Home Phone: (____) ____ - _______ ext. ______

Email Address: ______________________________________

Desired Dates:

Date Out _______/_______/_______ - Date In _______/_______/_______

Materials:

We occasionally send out free educational materials and activities. Would you be interested in receiving some of these materials?

Yes
No

This is not a contract. After your application is received you will be contacted by Laura Chase (707-664-3261) to confirm your reservation.

Signature: _________________________

Date: _____________________________