NERIC STEAM Lending Request Form

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NERIC STEAM Lending Request Form

PLEASE NOTE: This request is not confirmed until specific arrangements are made with a follow-up email. Adjustments may be made based on equipment availability.

Please request at least 2 weeks in advance.

This service is only available to NERIC Model Schools Districts.

Email *

Name *

Grade Level/Subject Area *

School District and Building *

Equipment Requested *

Pick-up and Drop-off Location *

**You will be contacted to plan a date and time for pick up and drop off appointments.**

Request Date Range *

Please put the approximate timeframe that you would like to use the equipment based on the calendar.

Each item has a calendar on their detail page that is updated daily. Please do not submit for any dates that are in red or grey.

Pick up must be on a Wednesday after 12pm or later that week.

Want to request extension kits, mats, iPads (limited) or anything else? Let us know! (Optional)

Any questions or comments? (Optional)

AGREEMENT: I take responsibility for this equipment within my district and with my students. I will make sure to return the chargers too. Please initial. *

Send me a copy of my responses.

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