Extended Loan Equipment
Sponsor Request and Authorization Form for Student Use
This form must be filled out and submitted in person at least 24 hours in advance of checkout at the
Circulation Desk in the John C. Pace Library by a currently employed UWF faculty member, adjunct, or full-time
staff member on behalf of a currently enrolled UWF student in order for the student to be eligible to check out
any of the equipment in this program.
Sponsor Information:
Name:
UWF Department:
UWF Extension:
UWF E-Mail:
Student Information:
Name:
Phone:
UWF E-Mail:
Equipment Information:
Equipment Requested:
Equipment Checkout Date and Time:
Equipment Return Date and Time:
I certify with my signature below, that I _________________________ have agreed to sponsor _________________________ and
have read and agree to abide by the Extended Loan Equipment policies outline at
(http://library.uwf.edu/about/policies/extended_equipment_loan.cfm). I am aware that I am assuming all legal and financial
responsibility for the equipment that is being loaned to the sponsored. This assumption means that I am the person that will be held
legally/financially responsible for any fines, fees, and/or replacement costs that the sponsored may incur due to equipment that is
damaged or lost/stolen while in the possession of the sponsored; in this event, circulation staff will furnish me with documentation
of damage/loss/theft of the equipment in order to illustrate the justification for any incurred costs. I understand that if the
equipment is 1 week past due, and the borrower fails to notify or respond to library staff inquiries then library staff will report the
equipment as lost/stolen to campus police, apply the full replacement cost of the equipment to my library and university accounts
(these fees will be removed as long as the equipment is returned in good working condition), and that I may permanently lose my
equipment loan privileges.
Sponsor’s Signature:
Date:
