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Equipment Loaner Program Form

Prior to checking out equipment, you must read and complete this form. Be sure to fill out all of the information. Please print it, sign it, and bring the form with you when you come to pick up the equipment that you are checking out.

  • Employee Information

  • BLDG Room

  • Equipment Loaner Agreement

  • Agreement

    Financial Responsibility: The department of the Equipment Loaner Program employee must agree to accept full financial responsibility for the costs associated with repair and/or replacement of the loaner equipment if it is damaged, lost, or stolen. If the loaner equipment is damaged, lost, or stolen, the faculty member will be required to notify the DoIT Business Office immediately and work with Campus Police as deemed appropriate.

  • Employee Signature (upon checkout)

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  • DOIT Signature (upon checkout)

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  • For Office Use Only

  • Employee Signature (upon return)

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  • DOIT Signature (upon return)

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