"Equipment Loan Agreement Template"

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Equipment Loan Agreement
STUDENT INFORMATION
Name
___________________________________________________________
Student ID
_____________________
Email
_________________________
Quarter
_____________________
Phone
__________________________
EQUIPMENT INFORMATION
Description
___________________________________________________________
Equipment ID
__________________
Chair Location
_________________
Checkout Date
__________________
Due Date
_________________
Date Returned
__________________
Return Accepted By
_________________
The equipment described and documented on this form is being loaned under the
following conditions:
 The equipment is to be handled carefully, not subject to abuse, solely by the above
named student.
 Any recordings made from a recording device are for the student’s use ONLY. The
information will not be shared, posted to the internet, sold, or disseminated in any
other way.
 If lost or damaged, the replacement cost will be the responsibility of the student.
 Equipment will be returned by the end of each quarter.
 A registration hold will be placed on the student’s college record until the
equipment is returned or replaced.
 The student’s account will be sent to collections if equipment is not returned after a
certain date.
I understand the above stated conditions and agree to abide by this contract.
____________________________________________
____________________________
Student’s Signature
Date
____________________________________________
____________________________
DSS Representative
Date
Equipment Loan Agreement
STUDENT INFORMATION
Name
___________________________________________________________
Student ID
_____________________
Email
_________________________
Quarter
_____________________
Phone
__________________________
EQUIPMENT INFORMATION
Description
___________________________________________________________
Equipment ID
__________________
Chair Location
_________________
Checkout Date
__________________
Due Date
_________________
Date Returned
__________________
Return Accepted By
_________________
The equipment described and documented on this form is being loaned under the
following conditions:
 The equipment is to be handled carefully, not subject to abuse, solely by the above
named student.
 Any recordings made from a recording device are for the student’s use ONLY. The
information will not be shared, posted to the internet, sold, or disseminated in any
other way.
 If lost or damaged, the replacement cost will be the responsibility of the student.
 Equipment will be returned by the end of each quarter.
 A registration hold will be placed on the student’s college record until the
equipment is returned or replaced.
 The student’s account will be sent to collections if equipment is not returned after a
certain date.
I understand the above stated conditions and agree to abide by this contract.
____________________________________________
____________________________
Student’s Signature
Date
____________________________________________
____________________________
DSS Representative
Date