San Diego City College Laptop Loaner Program Technology Request and Agreement Form (Due to high demand, laptop loan applications are taking longer to process. New applications may be placed on a waitlist. First 2 weeks of the Spring semester priority will be giving to students taking 6 or more units at City College. Thank you for your patience as we work to get laptops to as many students as possible)
ACCEPTANCE OF RESPONSIBILITY AS A BORROWER
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Email *
Student First Name /Nombre del Estudiante *
Student Last Name /Apellido *
Student ID Number /Numero de Identificacion del Estudiante *
Contact Number / Numero de Contacto
Home/Mailing Address / Direccion *
Are you participating in any special programs, such as STEM, EOPS, or CalWORKs? If so, please indicate which ones below
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Do  you need/ Necesitas *
Required
You, the borrower agrees to return the equipment in the same condition as when loaned and further agrees to reimburse the District for any loss or damage incurred while the borrower has custody.   Normal wear and tear is excluded *
Required
This device is to be used for educational and school-related purposes.  Failure to return the devices timely will result in a hold on the borrowers account.  As the borrower, I  further agree to indemnify hold the SDCCD HARMLESS for all activities from any and all claims, actions, suits, procedures, costs, expenses damages and liabilities, including attorney fees brought as a result of either removing, transporting and returning said loaned equipment to the SDCCD. *
Required
I further understand that all loaned equipment must be surrendered to the SDCCD upon demand.   *
Required
A copy of your responses will be emailed to the address you provided.
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