UWL Music Department Locker Request Form
Our instrumental lockers are conveniently located in room CFA56, just outside the large ensemble classroom in the basement of the CFA.

Lockers are rented per semester for a fee of $10.00 per lock, per semester. Multiple semesters may be paid for at once. Locker rental end dates are usually no later than noon on the last day of finals. Notices will be displayed in the locker room.

You must use the lock provided by the department and using your own lock is prohibited.

All lockers will be assigned at the sole discretion of Sharon Shugrue, Music Lab Associate. If you have any issues or questions, please contact her at the Music Listening Lab at CFA124, sshugrue@uwlax.edu, call 608-785-8415 or text 608-792-5585.

Despite the swipe key access, the locker room is NOT secure. UWL and the UWL Music Department are NOT RESPONSIBLE for any lost or stolen items. Please keep all items properly secured at all times. 

ALL INSTRUMENTS AND PERSONAL ITEMS *MUST* BE KEPT IN A LOCKER - ANY INSTRUMENTS IN THE BUILDING FOUND NOT IN A LOCKER WILL BE CONFISCATED.

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Email *
PROCEDURE
Please fill out this form completely. All answers are required.

SUBMIT THIS FORM ONLY ONCE. Like an elevator, pressing the button multiple times will not get you what you want any faster.

After receipt of your data, you will need to meet with Sharon to choose your locker and hand her your fee. She will furnish you with a receipt showing your payment, locker number, lock number, and combination. (ONLY Sharon can do this transaction with you).

(SEMB will meet Sharon at SEMB Registration on Sunday, 8/28/22)

Payment must be made via cash or check only. Please make checks out to "UWL Music Department"

Payment may also be dropped off after hours or in Sharon's absence into the Music Lab Drop Box - (Orange locker number 2-087 just outside the Music Listening Lab, CFA124).  Please be sure to use the envelopes provided at the drop box and that your name appears on the envelope so your account is correctly credited.
Student ID number *
Last Name *
First Name *
Address (if you live on campus, use dorm name & room number only) *
Phone Number *
Which ensembles are you in? (check all that apply) *
Required
List all instruments you wish to keep in this locker: *
The rental fee for instrumental lockers is $10.00 per lock, per semester. How many semesters would you like to rent for? *
Locker 2-087, the Music Lab Dropbox - Use after hours or in Sharon's absence
AGREEMENT
By submitting this data and locker rental request, you agree to the following:

I hereby agree to hold myself responsible for any damage or theft that may affect this lock and locker space through negligent use. This equipment is on loan from the University and must be relinquished upon request of the Music Department. I understand that I am responsible for renewing or returning my lock by the specified due date at the end of each rental term (i.e. fall, spring, summer), or I will be subject to a $25 processing fine. My maximum liability is the replacement value of the lock and/or locker space in addition to the fine. I am responsible for understanding and obeying loan term due dates. I agree to check my student email for notifications with regard to due dates and University requests. I agree not to store anything flammable, illegal, or perishable in this locker, nor decorate nor deface it in any way. I agree to report any issues to Sharon Shugrue in the Music Listening Lab, CFA124, sshugrue@uwlax.edu, 608-785-8415 or Nichole Novak, Music Department ADA in CFA234, nnovak2@uwlax.edu, 608-785-8409.
 

A copy of your responses will be emailed to the address you provided.
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