School of Media and Communication EQR Agreement
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This SOMC Equipment Check Out agreement is for the FALL 2023 Semester ONLY.
NAME (First and Last Name) *
USM STUDENT ID (ex. w1000001) *
Classification *
Required
Major *
Required
 CURRENT ADDRESS *
HOME MAILING ADDRESS *
PHONE NUMBER *
USM EMAIL (ex. seymour.eagle@usm.edu *
Alternative EMAIL *
I have carefully read the SOMC Policy and Procedure Handbook in full, and I understand the procedures of the SOMC Equipment Checkroom. I agree to abide by these guidelines in my dealings with the Equipment Office and in my use of the SOMC equipment. I accept full responsibility for the replacement cost of all items lost or broken while checked out under my name. *
Required
I acknowledge that I have received, read, understand, and agree to the information presented in the Equipment Checkout Agreement. I have had all my questions fully answered and have been given a copy of this document for my records. My signature below shows that I understand and agree with all of the statements provide in this presentation and Handbook. *
Required
DATE *
MM
/
DD
/
YYYY
By typing my first and last name below, I am confirming that I fully understand and have reviewed the School of Media and Communication equipment checkout and resource reservation policy presentation. * *
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