HEADER

COMPUTER LABORATORY EQUIPMENT BORROWER’S FORM

Control No. _____________

Teacher: ______________________________ Date Prepared: ______________________

Type of Equipment to be borrowed: (Please check one)
• Laptop/Projector  Mouse  CPU/Monitor  Headset/Speaker
• Keyboard  Others: (please specify) _________________________
Expected Date of Return: ________________________ Serial No. ______________________________
Purpose:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Agreement:
1) I hereby agree to the full responsibility for the care and use of the above equipment including its part and peripherals until it has been returned.
2) I hereby agree to exercise appropriate care in using and guarding the equipment and shall not allow any unauthorized person to borrow and use the same without
the permission of appropriate authorities.
3) I hereby agree to return the above equipment complete with all its parts and peripherals at the specified date in good working condition.

Requested by: Approved by:

______________________________________ ____________________________________
SIGNATURE OVER PRINTED NAME PROPERTY CUSTODIAN

Received by:
____________________________________
ICT Coordinator

ICT Coordinator’s Copy

HEADER

COMPUTER LABORATORY EQUIPMENT BORROWER’S FORM

Control No. _____________

Teacher: ______________________________ Date Prepared: ______________________

Type of Equipment to be borrowed: (Please check one)
• Laptop/Projector  Mouse  CPU/Monitor  Headset/Speaker
• Keyboard  Others: (please specify) _________________________
Expected Date of Return: ________________________ Serial No. ______________________________
Purpose:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Agreement:
1) I hereby agree to the full responsibility for the care and use of the above equipment including its part and peripherals until it has been returned.
2) I hereby agree to exercise appropriate care in using and guarding the equipment and shall not allow any unauthorized person to borrow and use the same without
the permission of appropriate authorities.
3) I hereby agree to return the above equipment complete with all its parts and peripherals at the specified date in good working condition.

Requested by: Approved by:

______________________________________ ____________________________________
SIGNATURE OVER PRINTED NAME PROPERTY CUSTODIAN

Received by:
____________________________________
ICT Coordinator
Guard’s Copy