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Equipment Loaner Program Form

To reserve the loaner equipment, you must read and complete this form. Be sure to fill out all of the information. Once you have received an email approving your request. Please come to the Help Desk located in room 112 of the IT Convergence Center to check out the equipment.

  • 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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