Fall 2021 PVCC Student Laptop/Equipment Request and Property Loan Agreement
Please fill out the following form to request a laptop. This request does not guarantee you will be issued a device, this is a preliminary request. Students who receive a checkout device will have a financial hold put on their student account for the replacement value of the equipment ($1,100 Laptops, $73 Hotspots)


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Email *
First Name *
Last Name *
MEID (Student email) *
Student ID number *
Starts with a 3xxxxxxxx; Log into your myinfo.maricopa.edu -> Check your Profile and your ID will be listed
Mobile Phone Number *
Courses you are enrolled in: *
Add a comma between each course: ENG101, SOC101, MAT151 etc
Equipment
Do you have access to the internet? *
You must provide your own Internet access. If you do not have internet access select I need a hotspot.
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