RR Equipment Loaner

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

RR Equipment Loaner

I understand that, by completing and submitting this form, I assume financial responsibility for returning the borrowed equipment in the condition in which it was received. I further understand that I cannot use such equipment for purposes of personal gain or profit, per District Regulation EDB-R, Maintenance, Control, and Use of Materials and Equipment.

First Name *

Last Name *

Laptop Serial Number (ex: 8YNF52)

Laptop Condition

Good

Poor

Clear selection

Please note any issues with laptop performance. (5 min or more to boot, missing keys, loose connection points, etc)

I-Pad Serial Number (S/N icon on desktop)

I-Pad Condition

Good

Poor

Clear selection

Please note any issues with iPad performance.

Document Camera

Good

Poor

I don't have a document camera

Clear selection

Chattervox

I do NOT have a chattervox

Good

Poor

Clear selection

Location of equipment for duration of loan. (Enter your summer address OR enter N/A at BOY)

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Jefferson County Public Schools. Report Abuse

Forms