TECH_Splore Table Rental Interest Form

First Name *

Last Name *

Email *

Phone *

Please provide a brief description of what you plan to display. *

Will your display need more than basic access to electricity / Wi-Fi? *

Yes
No
Maybe

If you replied "Yes" or "Maybe" to the question above, please explain what resources you might need.

Are you a current member of Mimms Museum? *

Yes
No
Not sure

By selecting "I agree," I affirm that submission of this application does not guarantee approval. Further, I understand and acknowledge that there are inherit risks associated with displaying my collection to the public, including the possibility of property damage. *

I Agree

Timeout Warning

TECH_Splore Table Rental Interest Form