Equipment Checkout

NOTE: A faculty or staff person must take responsibility for the equipment when checking it out. The faculty or staff member is required to sign the equipment out. Students will not be allowed to pick up, or sign out the equipment. If the faculty or staff member wishes to trust the student to return the equipment, that is up to them, but they remain responsible for the equipment until it is properly signed back in.

Please fill out the form below to request equipment:

Equipment Checkout Form
Faculty/Staff Name:
Faculty/Staff Email Address:
Faculty/Staff Phone:
Class Location:
Equipment Requested: (Item one required, additional items optional.)
Item One	Item Two

Item Three	Item Four

Department and Course (or Event):	Example: CS 110 Example: Faculty Workshop
Date Equipment needed:
Time Equipment needed:	From: To: Please include am/pm.
Date equipment returned: (if not returned the same day)
Check here if you need access to the network:
Are there any special needs not addressed elsewhere in this form? Examples would include special software installed on the laptop or a dial up connection.