To reserve your Mini-Fridge, complete this form and return it with your full payment of $90 + 20 (security deposit) to Mini-Fridge Rentals. Payments received by August 4, 2003, will be installed the day you move in. If your payment is received after August 4, 2003, the Mini-Fridge will be installed within the first two days of move in.

Student’s Name ______________________________________________________________________

Home Address  ______________________________________________________________________

 City _____________________________________________ 

 State ___________________ Zip  _______________________

 Home Telephone ___________________________________

 Residence Hall Name ________________________________

 Room Number _______________________________________

 School Email Address _______________________________

 Roommate’s Name ___________________________________

Mini-Fridge Rentals will only accept one lease and one payment per Mini-Fridge. Reimbursement/sharing of costs must be handled between the roommates. Should roommates choose to share the cost of a Mini-Fridge, one student will be held responsible for the equipment by this lease. All refunds and/or additional charges will be communicated with the lessee. Split payments will be returned to the responsible parties.

Total Cost: $90 per Mini-Fridge for academic year 2003-2004

Payment Method: 
 Check enclosed made payable to:
 Mini-Fridge Rentals for $90 + $20 (security deposit) = $110

Full payment must accompany the order and will be processed upon receipt. Returned checks will result in a $25 service charge.

The lessee agrees to reimburse Mini-Fridge Rentals for any and all loss or damage to the rental unit from any cause whatsoever. In the event that the unit is not returned, the replacement cost for the rental unit will be $250 per unit. 

The lessee shall be responsible for having the Mini-Fridge defrosted, clean, dry and ready for pick up at the end of the academic year. A $20 cleaning fee will be charge for units returned unclean.

The unit must have all original parts intact.  Lessee agrees to pay for replacement of parts not returned with the unit.

It is the responsibility of the student to notify Mini-Fridge Rentals if they are leaving school or changing rooms. If the unit is not available for pick-up, the lessee will pay the replacement cost of $250 for the rental unit.

Refunds will be granted for the first 30 days less a $40 processing fee.

The lessee acknowledges that the Mini-Fridge unit requires a grounded three-prong outlet. If the student’s room does not have a proper outlet, a grounded adapter must be used. If an extension cord is used, it must be a three-prong extension cord with a wire gauge no thinner than #18 wire.

I, the lessee, understand and agree to the terms of this agreement.

Signature ___________________________________________ Date __________________