UK FMD Equipment Check-Out Request Form
Thank you for your interest in UK Faculty Media Depot Resources. Please fill out this form to request an equipment kit check out. A UK FMD representative will contact you shortly to confirm your request.
Email address *
First Name *
Last Name *
Employee ID Number (If applicable, do not include the 9 at the beginning) *
Department Name *
Phone Number (without spaces, dashes, etc.) *
Desired Check Out Date *
MM
/
DD
/
YYYY
Approximately how long will you need the equipment?
Desired Equipment Kit
Additional Equipment Needs
Have you checked out equipment with us before?
Clear selection
Additional Notes
Submit
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