Teacher Equipment Check Out 22-23
Please fill out this form for any equipment that might leave the building to go home or to a conference.
Sign in to Google to save your progress. Learn more
Email *
Last Name *
First Name *
Home Address *
Date equipment is being checked out *
Anticipated return date *
Laptop computer (plus cord)  SERIAL NUMBER
located on bottom of computer 
Laptop Computer Model
(example:  ThinkPad E15 Gen 2)
Laptop condition
(excellent, good, or poor - please list ANY problems)
Apple iMac SERIAL NUMBER
located in Settings - General - About - Serial Number
iMac condition
(excellent, good, or poor - please list ANY problems)
Chromebook serial number
Chromebook condition
(excellent, good, or poor - please list ANY problems)
I understand that, by completing and signing this form, I assume financial responsibility for returning the borrowed equipment in the condition in which it was received.  I further understand that I cannot use such equipment for purposes of personal gain or profit per District Regulation EDB-R *
(please answer yes!)
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Jefferson County Public Schools. Report Abuse