Equipment Loan Agreement Form printable pdf download

Equipment Loan Agreement Form

Name: __________________________________

MyWSU ID#:___________________________

I accept full responsibility for the equipment, software, and peripherals that I am borrowing. I will reimburse the

Wichita State University Libraries the full cost of repairing or replacing any of this equipment and software should

they become damaged or lost while checked out in my name.

I agree to pay any overdue fines that may occur pursuant to the WSU Libraries Equipment Circulation Use and

Liability Policy.

Should I refuse or fail to return library equipment, I understand that WSU Libraries may refer the account to the

Wichita State University Police as a criminal matter.

I understand that the loan period is for four hours or until one hour before closing, whichever comes first.

I understand that the equipment may not leave through Ablah Library’s main entrance, even for use in the library

foyer or Edmiston 24 Hour Study Room.

Each item will be inspected upon checkout and return for the following:

Item#

Additional Cords when applicable

Physical Condition of Item

Item Powers Up

Carrying Case

I acknowledge that damage to any of the above components may result in charges to my

library account.

With my signature below, I verify that I have read, understand, and agree to abide by all guidelines in

WSU Libraries’ Equipment Circulation Use and Liability Policy and Wichita State University’s

Acceptable Use Policy as included in the WSU Policies and Procedures Manual, Chapter 19 Section 01.

Violation of these policies may result in my equipment checkout privileges being revoked at the

discretion of WSU Libraries administration and/or University Computing.

Borrower’s Signature: __________________________________ Date: ________________________

Staff initials_______________

11/29/12 CEM

Equipment Loan Agreement Form