Multimedia Center Equipment Request Form
Contact: Julio Mata

405-974-5595

 

 

Faculty / Staff / Student Organization Sponsor Only

  Please enter your name:

Department

  Please enter your department:

Phone:

  Please enter your extension/contact number:

Email:

  Please enter your UCOK email:

Day of the week


Date:

 Please enter date the equipment will be picked up:

Date:

Please enter the date equipment will be returned: ( Maximum of 3 days )


Time:

  Please enter time the equipment is needed:

 

 

 

 

   
 The Technology Resource Center (TRC) at the University of Central Oklahoma agrees to loan the above named individual (borrower) the equipment indicated at the top of this form.  Borrower agrees to return above listed equipment in good working condition, and further agrees that he/she is personally responsible for any theft, loss, or damage to the above listed equipment.
 

 Please Pick up Equipment in Lillard Administration building  RM 101 during the hours of Monday-Friday 8:00am-5:00pm

trc/TRC-Media Center Policies and Procedures.pdf

 

           Signature:___________________________   Date:___________________

                                                                                                     

 Form will be provided by Technology Resource Center at time of pick up and signature will be required .