Equipment Checkout Form for Out of School Use
Please identify the device that you would like to check out. You will receive a confirmation email with an attached form that will need your signature, as well as your principal's approval.
Name
Your answer
School Email Address
Your answer
Home Address
Your answer
Phone Number
Your answer
Building
1st Item Requested
Item Requested (1)
SDR Bar Code (1)
Your answer
Service Tag Number / Serial # (1)
Your answer
2nd Item Requested
If applicable
Item Requested (2)
SDR Bar Code (2)
Your answer
Service Tag Number / Serial # (2)
Your answer
Intended use of the equipment:
Your answer
Date(s) equipment will be taken out of the building
Your answer
I understand that I am personally responsible for the cost of repair and/or replacement of the item(s) identified above. In the event that equipment is lost, stolen, or damaged, I am required to reimburse the District either through renter’s/homeowner’s insurance or personal finances. If reimbursement action has not been proven within two weeks of the anticipated return date, the District will initiate procedures to secure funds through payroll deduction to the extent provided by law. I agree that I will obtain the building principal’s signature indicating item(s) returned and in working condition on return date identified below.
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