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Equipment Loan Request Form – The Center for Simulation & Immersive Learning
Equipment Loan Request Form – The Center for Simulation & Immersive Learning
Center for Simulation & Immersive Learning – Equipment Loan Request Form
Requestor’s Name
(Required)
First
Last
Requestor’s Phone
(Required)
Requestor’s Email
(Required)
Purpose of equipment request
(Required)
Internal Order or Budget Number
(Required)
What date are you requesting to pick up the equipment?
MM slash DD slash YYYY
What date will you be returning the equipment?
What date will you be returning the equipment?
MM slash DD slash YYYY
Please list the equipment and quantity that is being requested.
(Required)
Have you used this equipment before?
(Required)
Yes
No
If not, you must dedicate time to obtain a brief training on the equipment you are using before pick up date.
Terms and Conditions: Requester agrees that the equipment will not be subject to unnecessarily rough usage, it will be used in accordance with its design, and that its use will conform to all applicable policies and regulations. Requester agrees not to allow the use of the equipment for illegal purposes or for operating requester's own or another's personal or commercial business. If equipment is destroyed, damaged beyond reasonable wear and tear during intended use, or lost under any circumstance, requester will be held liable and will be required to reimburse for the cost of returning the equipment to its original state. If equipment does not meet the required standards established by the Center for Simulation & Immersive Learning, requester will be required to pay to have that equipment replaced with the same brand and model equipment. If requester is unable to secure the exact model, an upgraded brand and model determined by the Center for Simulation & Immersive Learning will be purchased by the requester as a replacement.
(Required)
Please sign to the agreement. Your electronic signature indicates you have agreed to the above terms and conditions.
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