Reserve The Music Box Van

Name on Lease *

First

Last

Please use only the primary leaseholder's name. If the room is under a business entity name, please use the primary contact person.

Room Number *

Leaseholder's rented room (e.g. D.3, 14, 105)

Email *

Leaseholder only

Phone *

Leaseholder only

Preferred Pickup Time *

Date

Time

Estimated Return Time *

Date

Time

File Upload *

Click or drag a file to this area to upload.

Please submit a single photo of your current Automobile Insurance AND valid Driver License together.

Purpose for Use *

Terms & Conditions *

I agree that by submitting this form, I have valid and current automotive insurance coverage. I am liable for any damages to the vehicle while in my possession.