Locker Agreement Form for 2012-2013

Organization Name:
Organization Email:

President Information
Name:               
Winthrop Email: 
Phone Number: 
WU ID#:               

Advisor Information
Name:  
Email: 

In addition to the President and Advisor listed above, four students can be granted access to the organizational locker.

Student #1
Name:               
Winthrop Email: 
Phone Number: 

Student #2
Name:                 
Winthrop Email:  
Phone Number:  

Student #3
Name:                
Winthrop Email: 
Phone Number: 

Student #4
Name:                
Winthrop Email: 
Phone Number: