Portable Equipment Request (2013-14)

This form is to be completed by USI EMPLOYEES to borrow equipment for university-related activities ONLY, and is NOT FOR PERSONAL USE. A university account number is required- charges may apply. Questions? Contact us online at instructech.usi.edu , or call us at 464-1838.
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1. Please type your name.
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2. Please type your complete EMAIL address.
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3. Type the telephone number where you may be reached if we have any questions.
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4. Select area where you work at USI.
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5. Please have the fiscal agent email IT their approval and provide an account number.This account will be charged in the event the equipment is damaged.
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6. State the meeting or the purpose for the loan.
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7. Select the equipment you need from the list below:
8. Didn't see what you need on the list above?
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9. What date do you need to pick up equipment?
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10. Type the time you need to pick up the equipment. PICK-UP TIMES ARE: M-F 8:00 a.m. to 4:15 p.m.
 HH MMAM/PM
Pick up time: 
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11. What date will you return equipment?
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12. Time you will be returning equipment. RETURN during business hours: M-F 8 a.m. to 4:15 p.m.
 HH MMAM/PM
Return time: 
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13. IF THIS DOES NOT APPLY, skip question. Select box if you have questions or need assistance.
PLEASE PRINT A COPY of this completed form for your records and review it before continuing.
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