Equipment Loan Form
This form provides guidelines for borrowing equipment from Berkeley City
College. Before removing equipment or furniture from the premises an employee
must have written approval from their supervisor.
Lender Information:
Department Name:______________________________________________________________
Borrower and Equipment Information:
Borrower:__________________________________Phone Number:________________________
Address:________________________________________________________________________
Loan Period:
From:______________________________To:____________________________________
Equipment Details: (use additional pages as needed)
Equipment Security (Please check each box):
____ I confirm that I will keep equipment, especially technology equipment, secure at all times.
____ I confirm that I will return the equipment in the condition in which it was received.
Unit Approval:
________________________________________________________________________________
Signature Printed Name/Title Date
Part A – Routing Instructions:
1. Copy to Unit Supervisor
2. Copy to Business Office (Attention: John Pang)
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signature
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