Property Control Form No. 7

Description

PROPERTY CONTROL FORM NO. 7 Revised June 2014 STUDENT/FACULTY OFF CAMPUS USE OF STATE PROPERTY DATE: STUDENT/FACULTY NAME: ADDRESS: TELEPHONE NUMBER: The following state property is periodically loaned, in conjunction with class work, to the above referenced student/faculty member during the ________ semester, __________. By signing below, the student or faculty member acknowledges that he/she shall be held responsible for any damage or loss of equipment. Failure to reimburse the University for loss or damage, shall result in the indebtedness of the student or faculty member to the University. In addition to this form, user shall sign a log sheet in the LRC each time the equipment is taken off campus and returned. DESCRIPTION OF EQUIPMENT: __________________________________________ STUDENT/FACULTY SIGNATURE APPROVED BY: COURSE INSTRUCTOR: _______________________________________________________________ DEPARTMENT HEAD:_________________________________________________________________ DIRECTOR OF PROPERTY CONTROL:____________________________________________________ To be completed at the end of the semester, Student/faculty and department head shall sign below acknowledging the return of all state property used during said semester. __________________________________________ STUDENT/FACULTY MEMBER __________________________________________ DEPARTMENT HEAD NOTE: When completed, form must be forwarded to the Property Control Office.