Annex H

March 2009
THE SINGAPORE SCOUT ASSOCIATION

EQUIPMENT LOAN FORM

Part A (Personal Particulars)

Name: ____________________________________ I/C: ________________ Date of Birth: _____________

Driving Licence (applicable of loan of vehicle) Class:_____________________ Expiry Date: _____________
Tel: ____________________ (O) _____________________ (R) _____________________ (HP)
Scout Group: ___________________________________________ Area//District: ____________________
Signature: ______________________________________________ Date: __________________________
Part B (Equipment List)
Equipment Qty From To Purpose of Use Location of Use Remarks
LAPTOP 1 (HP) IMPORTANT NOTES:
• This vehicle is
LAPTOP 2 (HP) restricted to Singapore
use only.
LAPTOP 3 (HP) • No refund will be given
LAPTOP 4 (IBM) for vehicle that returns
early.
PROJECTOR 1 (HITACHI) • User is liable to pay
total cost of repairs if
PROJECTOR 2 (NEC) insurance company
reject claims of
VISUALIZOR (AVER MEDIA) damages.
PORTABLE AMPLIFIER • User is liable to pay
excess $1,000 (own
VIDEO CAMERA damage only)
FLIP CHART • User is liable to pay all
parking fines, traffic
GPS summons.
OHP • Extension: One day’s
WHITE BOARD advance notice is
required otherwise no
WALKIE TALKIE extension will be
allowed.
TROLLEY BAG
User is to top up full tank of
SCOUT VAN petrol (unleaded) when
OTHERS vehicle is returned.

Part C (Approval) Part D (Acknowledgement of Receipt)

Approved / Not Approved
______________________
Executive Director
The above equipment(s) are received in good condition except for the following
observations, (if any)
Issued by:
___________________ _______________
Staff Name & signature Date

______________________ ___________________ _______________

Date Applicant’s Signature Date
Part E (Return of Equipment) Part F (Follow Up Actions)
The above equipment(s) are returned in good condition except for the following
damaged/defective, (if any)
Received by:
___________________ _______________ ______________________
Staff Name & signature Date Executive Director

___________________ _______________ ______________________

Applicant’s Signature Date Date