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Equipment Loan Request Form

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Untitled Document

Students, please see our equipment loan policy for students .

Faculty and Staff, please see our general policies on equipment loan.


Fields labeled in red are required  
Your contact information
 
First name
Last Name
email address
phone number
Department
Affiliation
 
If you're making this request on behalf of somone else, please identify that person; students, please identify the instructor for your course
First name
Last Name
email address
phone number
Department
Affiliation
 
 
 
 
Purpose of Loan
Is this request related to an SAS class or special event?
Course number or event description
 
Location of class or event
Building
Room #
When does the class session or event take place?
Start date (mm/dd/yyyy
/ /
End date (mm/dd/yyyy)
/ /
Start time
hour
 :
minute
End time

hour
 :
minute
   
Will you pick up the equipment at Multi-Media Services, or do you need it delivered to the course/event location?
When do you need the equipment delivered, or when will you come to pick it up from Multi-Media Services?
Date (mm/dd/yyyy)
/ /
Time
hour
 :
minute
When should we retreive the equipment, or when will you return it to Multi-Media Services?
Date (mm/dd/yyyy)
/ /
Time
hour
 :
minute
What equipment do you need?
Loans require your department's approval. Your business administrator will be asked to provide MMS with a university budget code and agree to accepts financial responsibility for loss or damage of any equipment provided by Multi-Media Services (MMS). Please provide us with your BA's name and email address so we can request confirmation.
Business admin contact's name Business admin contact's email
Other instructions or information about this loan request