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LABORATORIES EQUIPMENT BORROWING FORM
Department of Electrical and Electronic Engineering, Faculty of Engineering, UPM
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APPLICANT INFORMATION
Name
*
Your answer
IC Number
*
Your answer
Designation
*
Choose
Postgraduate (PhD/Post Doc.)
Postgraduate (Master)
Undergraduate
Research Assistant
Lecturer/Staff
Matric Number / Staff Number
*
Your answer
Telephone Number
*
Your answer
Email Address
*
Your answer
Supervisor's Email Address
*
Your answer
Mailing Address
*
Your answer
EQUIPMENT INFORMATION
Equipment Name & Model
*
Your answer
Quantity
*
Your answer
Serial Number
*
Your answer
Lab Name
*
Your answer
Borrow Date
*
MM
/
DD
/
YYYY
Expected Return Date
*
MM
/
DD
/
YYYY
Reason for Borrow
*
Your answer
Declaration
*
I hereby declare that I will be fully responsible for any damage and loss of the equipment
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