Independence Community College serves the best interests of students and the community by providing academic excellence while promoting cultural enrichment and economic development.

Mission

Property Damage Report

If you experienced any issues or damage while using the rental equipment, please complete this form at the time of return. Honesty and detail help us keep rentals safe and available for everyone.

Contact Information

Pick Up Person *

Pick Up Person Phone *

Pick Up Person Email *

Church Name (Association) *

If not association - fill out

Pastor Name *

Person responsible for payment *

Person responsible for payment email *

Rental Start Date *

Rental End Date *

Damage Item Info

Item(s) Damaged: *

Description of Damage(s): *

Circumstances Resulting in Damage(s): *

Person Reporting Damage(s): *

Date of Report: *

By checking this box, I consent to receive marketing and promotional messages, including special offers, discounts, new product updates among others. Message frequency may vary. Message & Data rates may apply. Reply HELP for help or STOP to opt-out.

Privacy Policy | Terms of Service