Bike Locker Rental Form 

*** Please uses Firefox to complete this form. ***

This school year enjoy a Bike Locker for only $60.00 + $20 deposit.
While supplies last!

Please complete the following form. You will be forwarded to our online payment system to pay by credit card.
One Calendar Year: $130.00 ($110 + $20 refundable deposit)
Two Academic Semesters: $80.00 ($60 + $20 refundable deposit)
One Academic Semester: $50.00 ($30 + 20 refundable deposit)
Summer Session: $10.00

*Contract Type:

If one academic semester, select needed semester:

*First Name:

*Last Name:

*W #:

Resident Hall:

Room #:

Campus P.O. Box #:

Campus Telephone:

*Cell Phone:

*Email:

*Permanent Address 1:

Permanent Address 2:

*City:

*State:

*Zipcode:

Country:
*Primary Locker Request:
Secondary Locker Request:
Promo Code:
Agree to Terms and Conditions:

Once on campus, students must come to the vending office to pick up a key. For questions or additional information call (307) 766-4104 or email us at vending@uwyo.edu


 *Required Field