CESA #4 STEM Library Checkout
CESA #4 has curated a host of STEM Instructional materials and resources. Use this form to check them out for use with your students.
Individual Requesting *
First and Last Name
Your answer
Email *
Your answer
Phone Number *
Your answer
School District *
Your answer
STEM Resource Library Item Requested *
Quantity Requested *
Your answer
Method of Transfer (van runs late August through early June): *
Check-Out Time Period *
I, the above-mentioned party confirm that the resources used are for educational, NON-PROFIT purposes ONLY. *
I, the above-mentioned party acknowledge that should any of the equipment components or accessories be lost or damaged, I maintain responsibility for repair or replacement costs. *
I, the above-mentioned party acknowledge that should any of the equipment components or accessories be suspected lost or stolen, it is my responsibility to notify CESA #4 immediately at (608) 786-4800 and ensure completion of a theft report with my local police department, if applicable. *
I, the above-mentioned party acknowledge that should any equipment components or accessories be returned to CESA #4 later than the indicated return date, I may be penalized in the form of a late fee, restricted access or the filing of a theft report if equipment components and/or accessories are not returned within (10) business days of previously-indicated return date. *
I have read and understand this document. *
Please enter your name and date.
Your answer
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