Equipment Request Form
Department *
Contact Person *
Your answer
Phone Number *
What is the best phone number to contact you?
Your answer
E-mail Address *
What is the best e-mail address to contact you?
Your answer
Date *
For which date do you need this equipment?
MM
/
DD
/
YYYY
Check-out Time *
When will you require this equipment?
Time
:
Check-in Time *
When will you return this equipment?
Time
:
Estimated Learners *
How many learners are expected to be handling the equipment?
Your answer
Skill Trainer
Which skill trainer are you looking to loan?
Loan Policy *
I have completed training for this skill trainer(s) and understand how to use and maintain this equipment. I will supervise utilization of this skill trainer(s) during the course. I will inform PSI staff about any noted damages to the skill trainer.
Required
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