Hamilton Order Form

1.  FIRST DELIVERY DATE:

TO BE ANNOUNCED More delivery dates will be posted after this date.

2.  SCHOOL:

HAMILTON COLLEGE

3.  COUNTY:

ONEIDA

4.  SCHOOL CITY:

CLINTON

5.  SCHOOL STATE:

NEW YORK

6.  SCHOOL ZIP:

13323

7.  ORDER METHOD:

INTERNET PHONE (office use only) MAIL (office use only) OTHER

8.  TYPE:

ORDER

9.  TODAY'S DATE:

mm-dd-yy (You must use dashes for date to be entered properly)

10.  ON CAMPUS RENTAL:

YES........

If you do not have the information for questions 11-14, don't worry.  You can email it to us as soon as you have it!  Our Email Address: rent62@dmcom.net

11.  HALL:

PLEASE SELECT BELOW HALL NOT ASSIGNED ANDREWS BABBITT BUNDY EAST BUNDY WEST BUNDY CARNEGIE DUNHAM EELLS FERGUSON KEEHN KIRKLAND MACINTOSH MAJOR MCINTIRE MILLBANK MINOR NORTH ROGERS ROOT SOUTH WALLACE JOHNSON OTHER If your hall is not listed, please add it to the Notes Line at the end of the form.

12.  ROOM:

13.  SCHOOL PHONE OR STUDENT CELL PHONE:

Or choose which to use when contacting student

14.  COLLEGE EMAIL ADDRESS:

15.  STUDENT'S FIRST NAME:

16.  STUDENT'S LAST NAME:

17.  YOUR FIRST NAME:

18.  RELATIONSHIP TO STUDENT:

PARENT SELF OTHER OFFICE

19.  HOME ADDRESS:

20.  HOME CITY:

 

21.  HOME STATE

22.  HOME ZIP:

23.  HOME PHONE:

24.  PRIMARY EMAIL ADDRESS:

25.  CLASS:

FRESHMAN SOPHOMORE JUNIOR SENIOR GRAD STUDENT OTHER

26.  FRIDGE TYPE:

MICROFRIDGE COUNTER HIGH CUBE

27.  FRIDGE PRICE:

28.  TOTAL PRICE:

Entering the total price into the box means you have read and understood the Terms and Conditions and you authorize this amount to be charged on your credit card. 

29.  CREDIT CARD NUMBER:  Visa/Mastercard

Example: 0000 0000 0000 0000 (You must use spaces between the numbers for credit card to be read properly.)

30.  EXPIRATION DATE:

Example: 0409 Please use the proper number for the month, not abbreviations. Please do not separate the month and year with any punctuation or spaces.

31.  STUDENT ARRIVAL DATE:

mm-dd-yy (You must use dashes for date to be entered properly)

32.    ARE YOU AN RA (RESIDENT ASSISTANT)?

PLEASE SELECT BELOW YES NO

 

33.  NON-FRESHMAN:  Did you rent a MicroFridge from us last year?

PLEASE SELECT BELOW YES NO

Please print the Form Confirmation page that appears after you submit the form.  It will be your only copy of this form.