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2008-2009 Staff Computer Loan Lottery Entry Form Return the completed entry form to Janet Lee at Human Resources UH 1900 by 5 00 p.m. on December 5 2008. Thank you for your interest in this year s staff computer loan lottery. Good luck First Name Print Department Phone Numbers Office Home or Cell E-mail Address Continuous Years of Service Requirement - Full-time regular staff members at LMU Westchester and Law School campus with at least two years of continuous service as of December 31 2008. If you are not sure contact Human Resources at 310-338-7718. Do you meet the above Continuous Service requirement Yes No Outstanding Computer Loan - As of December 31 2008 you do not have an unpaid computer loan balance with the University. Name M-Z 310-258-5449 20-Month Loan Free Period - If you have paid off a previous computer loan you must be loan free for at least 20 months as of December 31 2008. For example if a previous loan has been issued it must have been paid off no later than December 31 2006. PLEASE READ CAREFULLY To the best of my knowledge the above information is accurate. By checking this box I understand that my entry will be routed to appropriate personnel to verify the above answers. Thank you for your interest in this year s staff computer loan lottery. Good luck First Name Print Department Phone Numbers Office Home or Cell E-mail Address Continuous Years of Service Requirement - Full-time regular staff members at LMU Westchester and Law School campus with at least two years of continuous service as of December 31 2008. If you are not sure contact Human Resources at 310-338-7718. Do you meet the above Continuous Service requirement Yes No Outstanding Computer Loan - As of December 31 2008 you do not have an unpaid computer loan balance with the University. If you are not sure contact Human Resources at 310-338-7718. Do you meet the above Continuous Service requirement Yes No Outstanding Computer Loan - As of December 31 2008 you do not have an unpaid computer loan balance with the University. Name M-Z 310-258-5449 20-Month Loan Free Period - If you have paid off a previous computer loan you must be loan free for at least 20 months as of December 31 2008. Name M-Z 310-258-5449 20-Month Loan Free Period - If you have paid off a previous computer loan you must be loan free for at least 20 months as of December 31 2008. For example if a previous loan has been issued it must have been paid off no later than December 31 2006. For example if a previous loan has been issued it must have been paid off no later than December 31 2006. PLEASE READ CAREFULLY To the best of my knowledge the above information is accurate. By checking this box I understand that my entry will be routed to appropriate personnel to verify the above answers. Thank you for your interest in this year s staff computer loan lottery. Good luck First Name Print Department Phone Numbers Office Home or Cell E-mail Address Continuous Years of Service Requirement - Full-time regular staff members at LMU Westchester and Law School campus with at least two years of continuous service as of December 31 2008. If you are not sure contact Human Resources at 310-338-7718. Do you meet the above Continuous Service requirement Yes No Outstanding Computer Loan - As of December 31 2008 you do not have an unpaid computer loan balance with the University. Name M-Z 310-258-5449 20-Month Loan Free Period - If you have paid off a previous computer loan you must be loan free for at least 20 months as of December 31 2008.

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