Add New Equipment Request
Before filling out the rest of this form, please double-check the Check-Out calendar for availability

Before You Start--Please type "OTEN" (all caps, no quotes) in this box:

Use these boxes to request equipment for a single date or continuous series of dates

Date/time equipment will be picked up:
Month: Date: Year: Pickup Time:

Date and time equipment to be returned:
Month: Date: Year: Return Time:

Note: Do not fill out both sets of boxes. Fill out the boxes above if you are requesting for a single date or continuous series of dates. Fill out the boxes below if you want to sign up for recurring dates.
Use these boxes to request equipment for a certain day of the week (e.g., "every Tuesday") during a series of months
Day:
Starting in:Year:
Ending in:Year:
Pickup Time: Return Time:


Name of Requestor
Last Name: First Name:
email (a reminder will be sent to this address):


Equipment Requested [Before checking out equipment make absolutely sure the item isn't already checked out by someone else! The system will not tell you this; you have to look at the calendar and make the determination for yourself!]

iBook(s)

Digital Still Camera(s)

Digital Video Camera(s)

Airport Wireless Base Station
Sharp Projector #1
Sharp Projector #2
Epson Projector

Camera Tripod

Powerstrip #1
Extension Cord

 CDRW Burner w/Firewire
Scalar Digital Microscope Canon USB Flatbed Scanner
Document Camera #1
Document Camera #2
Document Camera #3
Document Camera #4 		Smartboard

Classroom Performance System ("clickers")

For MAT Use Only:

HP Laptop(s)

To Request Vernier Probeware, contact Kevin Carr (kcarr@georgefox.edu)



Information to Help Us Serve You Better

Grade Level for which equipment will be used :
How will you use this equipment?required

What is your objective for learning?*now required

* I agree to return all the equipment in good working condition.

 

 

Month: Year: Type:

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