Loaner Equipment Check Out - 2019-2020 School Year

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Last Name

First Name

Home Address

I understand that this loan period is through May, 2020.

(Please answer yes!)

Laptop computer (plus cord) SERVICE TAG or SERIAL NUMBER

located on bottom of computer (not the express service code!)

Laptop condition

(excellent, good, or poor - please list ANY problems)

Chromebook (plus cord) SERVICE TAG or SERIAL NUMBER

located on back of chromebook

Chromebook condition

(excellent, good, or poor - please list ANY problems)

Apple iPad SERIAL NUMBER

located in Settings - General - About - Serial Number

iPad condition

(excellent, good, or poor - please list ANY problems)

I understand that, by completing and signing this form, I assume financial responsibility for returning the borrowed equipment in the condition in which it was received. I further understand that I cannot use such equipment for purposes of personal gain or profit per District Regulation EDB-R

(please answer yes!)

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