Equipment Reservation Form

Personal Information

UT-EID:


Name:


E-mail address:


Phone number:


Department or Research Center:


I am a
Faculty member
Staff member
Student

Equipment Needed

Please note: all equipment is available for a minimum of 2 hours, a maximum of 3 days.

Available to Faculty, Staff, and Students
Laptop Computer
Projector

Available to Faculty and Staff only
Digital Camera
Wireless Conference Phone
PowerPoint Presentation Remote

Scheduling Information

Pickup date (mm/dd/yyyy):


Pickup time:


Is training required?
Yes -- arrive 30 minutes early
No

Return date (mm/dd/yyyy):


Return time:


Comments or special needs:

By submitting this form, I agree to the policies and terms of the ITG Service Desk for the Equipment Loan Program. I understand that I/my organization will accept responsibility for the loaner equipment and all additional components provided. My/Our responsibility shall include the care, maintenance, and security of any/all equipment and components entrusted to me/my organization.

I/my organization will be prompt in the return of the equipment to the ITG Service Desk as agreed. In the event that I/my organization is unable to comply with the stated deadline, it is my/our responsibility to notify the ITG Service Desk immediately with an acceptable reason for the delay in addition to the approximate time the equipment and/or components will be returned. I/my organization assumes all responsibility for repair/replacement at current market value.

Students responsible for late returns, loaner equipment damage, destruction or loss may be subject to an academic and/or financial bar placed on their record which will prevent future course registrations with the University of Texas at Austin until any/all deficiencies are cleared.

I have read and understand the conditions stated above.

Pick up location: ECJ 2.506