Equipment Request Form

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ECTC has equipment for loan to teachers within the consortium for educational/instructional purposes. To request the use of ECTC equipment, Read the following: I understand that I am personally accountable for the security and care of borrowed ECTC equipment, and will return it in good condition. I further understand that repair or replacement cost(s) of borrowed ECTC equipment due to negligence is my responsibility. I will pay for the cost of repairing or replacing equipment that was damaged or lost due to my negligence. (Ex. leaving it in an unlocked car or classroom, or transporting it in unsafe cases which may make a delicate screen shatter.) I further understand that if the equipment was accidentally damaged, (exp. a teacher/or student accidentally knocks it off a desk) then ECTC will pay for the repair.

If you agree to the above, complete the form below.

If the equipment is available, it should reach you within a week.

Name *

Date *

YYYY

Home Address *

Home Phone *

Cell Phone *

Personal Email *

School District *

School Building *

School Phone *

School Email Address *

Subjects)

Grade *

Equipment Requested *

I would like to borrow the equipment for: *

I know how to use the equipment because ... *

I plan to use the equipment ... *

Date I would like to request the equipment *

YYYY

I havre read and agree to the ECTC Acceptable Use Policy.

ECTC has equipment for loan to teachers within the consortium for educational/instructional purposes. I understand that I am personally accountable for the security and care of borrowed ECTC equipment, and will return it in good condition. I further understand that repair or replacement cost(s) of borrowed ECTC equipment due to negligence is my responsibility. I will pay for the cost of repairing or replacing equipment that was damaged or lost due to my negligence. (Ex. leaving it in an unlocked car or classroom, or transporting it in unsafe cases which may make a delicate screen shatter.) I further understand that if the equipment was accidentally damaged, (exp. a teacher/or student accidentally knocks it off a desk) then ECTC will pay for the repair.

If you agree to the above, please answer yes.

Yes

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