Robotics Trailer and Intern Reservation

This submission form is used to reserve and submit the rental papers for renting one or more of our robotics trailers as well as optional STEM interns to help manage the set up, running the event and tear down of the equipment.

The only option of payment is submitting a check (mailing instructions will follow).

Please download the required NOVA Equipment Assignment/Loan Form and fill out the required information. Please date and sign the rental form and submit online using this electronic form. You can download the form here: NOVA Form 105-005

Please address any questions you may have to systemic@nvcc.edu
Renters Information

Please provide information for the organization you are representing as well as contact information for at least one contact
Name of Organization *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Primary Contact Name *

First Name Last Name
Primary Contact E-mail *
Primary Contact Phone Number *

Area Code Phone Number
Secondary Contact Name

First Name Last Name
Secondary Contact E-mail
Secondary Contact Phone Number

Area Code Phone Number
Event Information

Please enter information about your event and times for dropping off and picking up.
Event Name
Please enter the name of your event as listed on Robotevents
Event Date

Month Day Year
Date for your event
Trailer Drop off date

Month Day Year
Date for trailer drop off
Trailer Pick up date

Month Day Year
Date for trailer pick up
Event Site Info
Information where to drop trailer off, time for set up, etc.
Document Upload

Please upload the signed NOVA Equipment Loan form (105-005). You can download the form at the top of this page, as well as a Google aerial image of trailer drop off/parking location
Signed NOVA Equipment Assignment/Loan Form 105-005 *
Google Aerial Map of trailer drop off/parking location
Pay by Check

Please select which trailer(s) you will be renting as well as the option of STEM Intern(s). Choose quantity in the drop down for each category, make note to the total amount box and follow the steps below for submitting the check for payment
VRC Trailer
$500 each
VEX IQTrailer
$500 each
STEM Intern
$250 each
Total $ *
Does not reflect any discounts
1. Please make check payable to Northern Virginia Community College
2. In the memo line please note "VEX Trailer" and indicate organization renting the equipment and date of event
3. Mail to:
  NOVA SySTEMic
  10500 Battleview Pkwy, Suite 221
  Manassas, VA 20109
Submission of rental agreement
By entering the date and your full name in the boxes below and clicking SUMBIT you agree to the following:
1. All packing and sorting guides will be adhered to
2. If any item is to break or become damaged during the course of the event it will be documented on the Broken Item List (provided with your rental agreement package) and an email to systemic@nvcc.edu will be sent with an explanation of the item that broke and how
3. If any of the procedures are not followed as listed above or it becomes obvious that there was disregard for maintaining the quality of the equipment a $200 sorting fee and/or replacement costs for the damaged equipment will be charged
4. Minor damage, wear and tear are expected and included in the rental fee. Restocking of paper items related to the referees and judges is also included in the rental fee
5. I authorize the charge of the rental to be paid by either check or credit card
6. I declare that all data given in this form and attachments are complete and true and I have the authority to legally bind my organization to this agreement and provide payment for such agreement
Date *

Month Day Year
Signature *
Should be Empty:

Renters Information

Event Information

Document Upload

Pay by Check

Submission of rental agreement