Hardware/software Equipment Check-Out

Hardware/Software Equipment Check-Out

All persons checking out equipment from the MIS Department must fill out and

sign this form. Any equipment checked out should be returned by the expected return

date written on this form. Any lost or damaged equipment will be the financial

responsibility of the person/persons who originally checked the materials out. For the

above reasons, the MIS Department highly recommends that equipment not be given to

anyone else to use. We thank you for your cooperation.

Name __________________________________________________________

Department Name________________________________________________

Equipment______________________________________________________

Date Checked Out__________________________

Expected Return Date_______________________

Date Returned_____________________________

Signature______________________________________

’s Signature_________________________________

Notes:

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Parent category: Life