Center for Teaching Excellence Equipment Request Form
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Email *
TIMESTAMP *
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Your COSMO ID# *
Requestor's First Name *
Requestor's Last Name *
Email Address *
Campus *
DEPT/DIV *
MATC Telephone EXT *
Home Telephone Number or Mobile Number *
Supervisor's Full Name *
Supervisor's Email Address *
Equipment Requested (please fill out a separate form for each piece of equipment needed)
How Long Do You Need the Equipment *
Reason for Use *
NO. Or MATC Tag (do not fill in this box) *
Checkout Date *
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Pickup time
Return Date *
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Return Status
Check this box to confirm that your supervisor is aware of and agrees to you checking out this equipment. :: I confirm that my supervisor has been notified of my request.
Short answer text
Copyright :: As an MATC faculty/staff member, I am aware that I am bound by the Federal Copyright Laws. Duplication of copyrighted print/computer/audiovisual materials is prohibited, unless a letter from the publisher granting permission to copy is on file in the Faculty Innovation Center, Milwaukee Campus. I individually assume full responsibility for illegal copying and realize I can be prosecuted according to the law. MATC assumes no support for such activity. I will abide by these laws in reference to this request. I will make the materials available for review by the TLT Dept. and my supervisor.
Short answer text
Fees/Charges Incurred :: I understand that any fees and/or additional service charges associated with this equipment are the responsibility of my Division/Department.
Short answer text
Open Records Law :: I understand that all information electronically stored on MATC-issued mobile technology equipment is subject to Wisconsin open records law and may be disclosed to outside parties.
Short answer text
Wi-Fi Use :: I understand that mobile wireless devices such as USB modems and hotspots have limited data capacity and cannot be used to download or stream music, videos (including YouTube), iTunes, Apps, pictures, radio, television, electronic books, animations, games, conferencing (such as Skype), or to make telephone calls online.
Short answer text
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