Provisional Equipment Request Form
Email address *
First Name *
Your answer
Last Name *
Your answer
VID *
Your answer
Phone *
Your answer
Check-Out Date *
MM
/
DD
/
YYYY
Equipment Requested *
Your answer
Reason for needing DMT equipment *
Your answer
I acknowledge that this equipment WILL NOT be used in either an internship or a for-profit project. *
I acknowledge that there is a ZERO-TOLERANCE policy in place and any infraction may result in a loss of equipment privileges, a hold on my grades, a fee and/or security being contacted at the Lab Manager's discretion. *
A copy of your responses will be emailed to the address you provided.
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