EQUIPMENT
CHECK-OUT
CHECKED OUT TO:
_______________________________________________________
CHECK OUT
DATE: ______________________ TO:
____________________________
LIST OF
EQUIPMENT:
ITEM:
__________________________________________________________________
SERIAL NUMBER:
_________________________________________________________
MODEL NUMBER:
_________________________________________________________
OTHER
INFORMATION: ____________________________________________________
RENTAL FEE:
____________________________________________________________
[if applicable and not related to school district business]
INSTRUCTIONS:
1.
COMPLETE THE CHECK OUT
SHEET AND OBTAIN BUILDING PRINCIPAL APPROVAL.
2. ON THIS DATE
______________________, I AGREE TO PAY FOR ANY DAMAGES/LOSS THAT MAY OCCUR TO
THIS EQUIPMENT WHILE IT IS IN MY CARE DUE TO NEGLIGENCE OR THEFT.
EMPLOYEE SIGNATURE:
_________________________________ DATE: ____________
PRINCIPAL APPROVAL :
__________________________________ DATE: _____________
EQUIPMENT CHECKED OUT BY: ____________________________ DATE:
____________
EQUIPMENT CHECKED IN BY: ______________________________
DATE: ____________
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