Holman Success Center Equipment Loaned Device Request

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First Name *

Last Name *

EID Number (Ex, E01234567) *

Emich email *

Which device are you requesting? *

Chromebook or laptop

TI Calculator

iClicker

How many courses are you taking this term? *

How many of your courses are online? *

Do you receive a Federal Pell Grant as part of your financial aid package? *

Yes

I'm not sure

Do you live on campus or commute? *

I live on campus

I live within 5 miles of campus

I commute from more than 5 miles away

Chromebooks, Dell Laptops, iClickers, and TI calculators are available on a first-come, first-served basis, while we have devices to loan. Submission of this request form does not guarantee that we will have a device available for loan.

Upon receipt of your loaned device, you will be asked to sign an "EQUIPMENT LOAN AGREEMENT." This agreement will contain all the details of your loan and the policies around the use of the device.

Contact the Holman Success Center with questions: HSC@emich.edu.

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