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Get Canby School District Laptop/Equipment Checkout Form 2005

Canby School District LAPTOP/EQUIPMENT CHECKOUT FORM This form is required for staff who wish to take their equipment off the premises of their respective building assignments. Any staff member that wishes to take their assigned laptop or other computer equipment off the premises will be responsible for its care and security. Those checking out equipment will be responsible for up to 100. 00 for the replacement or repair should the equipment require it due to loss neglect or abuse. Please list the item s that will be checked out. Equipment CSD Label Date Borrowed Serial Number if applicable Date to be Returned I understand that the following conditions will apply a* I will return the equipment to the building no later than the date indicated above. b. I will exercise reasonable care in transporting and using the equipment. c* I will be liable for the cost of repair and/or replacement of equipment damaged or lost up to a maximum of 100. 00. assessed the full replacement cost of that equipment. Staff Member Please Print Signature Date Home Phone APPROVAL Principal Supervisor or Designee Signature The item s have been returned and inspected for damages. Damages are noted as follows Item Damages This form will remain on file in the building office while the equipment is checked out. Any staff member that wishes to take their assigned laptop or other computer equipment off the premises will be responsible for its care and security. Those checking out equipment will be responsible for up to 100. 00 for the replacement or repair should the equipment require it due to loss neglect or abuse. Those checking out equipment will be responsible for up to 100. 00 for the replacement or repair should the equipment require it due to loss neglect or abuse. Please list the item s that will be checked out. Equipment CSD Label Date Borrowed Serial Number if applicable Date to be Returned I understand that the following conditions will apply a* I will return the equipment to the building no later than the date indicated above. Please list the item s that will be checked out. Equipment CSD Label Date Borrowed Serial Number if applicable Date to be Returned I understand that the following conditions will apply a* I will return the equipment to the building no later than the date indicated above. b. I will exercise reasonable care in transporting and using the equipment. c* I will be liable for the cost of repair and/or replacement of equipment damaged or lost up to a maximum of 100. b. I will exercise reasonable care in transporting and using the equipment. c* I will be liable for the cost of repair and/or replacement of equipment damaged or lost up to a maximum of 100. 00. assessed the full replacement cost of that equipment. Staff Member Please Print Signature Date Home Phone APPROVAL Principal Supervisor or Designee Signature The item s have been returned and inspected for damages. 00. assessed the full replacement cost of that equipment. Staff Member Please Print Signature Date Home Phone APPROVAL Principal Supervisor or Designee Signature The item s have been returned and inspected for damages. Damages are noted as follows Item Damages This form will remain on file in the building office while the equipment is checked out. .

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