To: Kathy Campoli, Manager
Please allow __________________________________________________
to borrow / pick-up (circle one)
from the Office of Information Technology (OIT) Help Desk, the following hardware item(s):
_____________________________________________________________
I agree to assume full financial and ethical responsibilities
for the above-named hardware.
I further agree that this hardware will be returned, by the
date due, in the same condition as it was when it was originally
borrowed, with all of its parts. In the event that this hardware
is not returned and / or it is not returned in the aforementioned
condition, the Customer Care Center will charge me for its replacement.
I will also be charged if any parts are missing when I return the
hardware.
My signature indicates that I have read and agreed to the
above conditions.
SIGNATURE___________________________________________________
Date_____________________
Faculty Member information below is needed to allow the
release of the above hardware to the person named above.
Faculty Member Number_______________________________________
Faculty Member Name_________________________________________
Campus Address_______________________________________________
Campus Phone Number_________________________________________
Home Address________________________________________________
Home Phone Number___________________________________________
FACULTY/STAFF ID CARD MUST ACCOMPANY THIS FORM
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