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This form is currently offline.'; return; //This function submits a text formatted email to the specified address function emailReceipt($emailArr) { $emailTo = ""; #$emailTo = ""; $from = $emailArr['Email']; $subject = 'Online Locker Request from ' . $emailArr['Name']; $body = "REQUEST INFORMATION: \n" . "\t" . 'Name: ' . $emailArr['Name'] . "\n" . "\t" . 'Email: ' . $emailArr['Email'] . "\n" . "\t" . 'Phone: ' . $emailArr['Phone'] . "\n" . "\t" . 'Degree: ' . $emailArr['Degree'] . "\n" . "\t" . 'Instrument: ' . $emailArr['Instrument'] . "\n" . "\t" . 'Needs: ' . $emailArr['Needs'] . "\n"; $emailHeader = "From: {$from}\nX-Mailer: PHP/".phpversion(); if ($foo = mail($emailTo, $subject, $body, $emailHeader)) { $ret = 1; } else { $ret = 0; } return $ret; } $form =

*Full Name





So that we can identify a locker that suits your needs,
please describe what you plan to store in your locker.
(please specify the number of instruments, types of instruments
and any special cases that hold multiple instruments):

Terms and Conditions

The University is not liable for any loss that might occur while using a University locker. The University suggests that all of the user's locker contents be insured on a homeowners or renters insurance policy in the name of the user or the user's parents.

Lockers are available for use by University of Maryland students, who are majoring in music or participating in a large ensemble within the School of Music program. All users must be enrolled in the current academic year.

A standard issue lock and combination will be made available to any person using a University locker.

Users have the option of purchasing their own lock for added security. Use of a lock other than the one issued by the University requires that the user return the University's lock to the School of Music Scheduling Coordinator (Michael Sparrow,, 301-405-1900) and that a combination or key be provided to the Scheduling Coordinator for the new lock.

Lockers will be available for use beginning on August 28, 2006 and ending on May 23, 2007. The contents of all lockers and any personal locks must be removed by May 23, 2007 unless special arrangements have been made with the Scheduling Coordinator. The University reserves the right to remove any lock, including personal locks, if the contents of the locker haven't been removed by May 23, 2007.

Lockers will be reissued at the beginning of the Fall 2007 semester.

* I agree to these terms and conditions

Consent and Release

In consideration of being permitted to use a University of Maryland (hereinafter the "University") locker, made available by the School of Music in the Clarice Smith Performing Arts Center, I (the undersigned) voluntarily agree to indemnify, release and hold harmless the State of Maryland, the University and its officers, agents, employees and volunteers from any and all costs, liabilities, expenses, claims, compensation, demands, or causes of action on account of any loss that might occur from use of said locker, whether arising through my own negligence, omission, default or that of the University.

I have read and signed this document with full knowledge of its significance. I further state that I am either 18 years of age or older and competent to sign this Consent and Release, or that I have discussed this with my parents/legal guardian, who agree with my decision to use a University locker and to all of the terms and conditions stated above.

* I agree to the terms of this consent and release

You will receive your locker assignment in two to three
business days from the time you submit your request.

Locker assignments and combinations will be sent
via a secure email.

Questions should be addressed to Mike Sparrow

EOHTML; if(!$_POST['Submit']) { //User has not entered input yet, display form echo $form; } else { //Form submitted, begin processing //Check for required fields $error = ''; if(!$_POST['Name']) { $error = $error . NAME
EOHTML; } if(!$_POST['Email']) { $error = $error . EMAIL
EOHTML; } if(!$_POST['Degree']) { $error = $error . DEGREE
EOHTML; } if(!$_POST['Instrument']) { $error = $error . INSTRUMENT
EOHTML; } if(!$_POST['Terms']) { $error = $error . TERMS AND CONDITIONS
EOHTML; } if(!$_POST['Consent']) { $error = $error . CONSENT AND RELEASE
EOHTML; } //Check if there were errors if ($error) {//All required information was not displayed //Display error $warning = You did not supply all required information
Please supply the following information
$error EOHTML; echo $warning; //Redisplay form echo $form; } else { //All required information submitted. send email if(emailReceipt($_POST)) { $message = Your request was submitted. EOHTML; } else { $message = There was an error with your request. Please try again. EOHTML; } echo $message; } } ?>