Equipment Loan Request Form for Students

Student Details

Staff Details

Name

Name

Department

Department

Library ID No.

Email/Ext

Equipment Booked

Late Returns may incur a charge

The above Student has been granted permission by the

_________________________________________________________________________

Department to borrow the listed items. On signing this form, I accept responsibility for taking reasonable care of this equipment. I understand that my department may be held liable for its replacement or repair if reasonable care is not taken

Collect (data and time)

Return (data and time)

Department Staff Signature

PRINT NAME