ERCs Item Check-out Request Form
Email address
Name
Your answer
Student ID # (or CA ID for staff/faculty):
Your answer
Phone Number:
Your answer
Resource Center Hosting the Event:
Organization/Affiliation:
Your answer
Item(s) Requested:
Required
Check-out Date:
MM
/
DD
/
YYYY
Check-out Time:
Time
:
Return Date:
MM
/
DD
/
YYYY
Please complete the captcha before submitting the form.
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