CHARACTER ANIMATION CUBICLE SPACE Name____________________________________ Yr . level ___________________ Cubicle #_____________________ Box #____________________________________ Telephone # ___________________ CalAr ts E-Mail _________________________ Alternate E-Mail _______________________________________________ Website URL/Blog_______________________________________________

I agree to accept responsibility for the cubicle space which is equipped with an animation desk, chair , cur tain and standard accessor ies. I will clean and return it to its proper condition. I will not remove any Institute proper ty in the cubicle from the CalAr ts building. * * I f you select a cube in the Lodge there is no painting allowed inside or outside of your cube. You may find other means of decorating without the use of paint.**

Date needed: From September 12, 2011 to May 18, 2012 Student Signature __________________________________Date _________________ Confirmation of cubicle assignment _________________________________________

(T.A. Signature)

DEPOSIT Deposit required: $40.00 Pay to Account #11-61-08-60 A $40.00 deposit is required for cubicle space. All deposits will be held until a damage repor t is made. Deposits will be returned through Martha Baxton or Jennifer Jeremich in the Character Animation Office of the School of Film/Video. Loss of deposit may occur from damage and/or misuse of the cubicle and equipment therein. Deposit Paid ______________ Roll-over Approved _____________ ************************************************************** This par t will be filled out at the end of the term. (2011-2012) Cubicle condition: Satisfactory _______ Unsatisfactory ______ Deposit Refunded: _________ Deposit Roll-Over: _________ Approved by:__________________