EQUIPMENT LOAN FORM
I assume the responsibility for the following district equipment:
Description ID Number
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
School-related purpose: (Note: items are not for personal use)
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
I will return the above equipment to_____________________________________
(administrator or designee)
no later than ___________________________.
(date)
In borrowing the items listed above, I assume responsibility for any loss of or damage to the equipment or materials. If any items are damaged or lost, I will pay the cost of repairs or replacement.
Signed: _______________________________________
Date: _________________________________________
Approved: _____________________________________
Date: _________________________________________
Exhibit SANTA CLARA UNIFIED SCHOOL DISTRICT
version: July 11, 2013 Santa Clara, California