Equipment Statement of Responsibility and Agreement

To check out equipment from the library, you will need to complete this form and provide current identification.
(student identification or a valid picture ID card)

First Name

Last Name

Cell Number/Telephone

A number, including Area Code, where you can be reached during regular business hours.

Student/Faculty/Staff ID number or Library Barcode

Borrower Information

Student

Faculty

Staff

Community Member

Campus or center you are located at

I Agree to the Following:

STATEMENT OF RESPONSIBILITY

I understand and acknowledge that I am personally responsible for the care, use, and security of NPC Library equipment while checked out. I agree to pay repair or replacement costs for items damaged or lost while in my care. I will examine equipment for damage prior to check out.

Sign Below:

Signature of Borrower

Equipment Statement of Responsibility and Agreement

To check out equipment from the library, you will need to complete this form and provide current identification. (student identification or a valid picture ID card)

STATEMENT OF RESPONSIBILITY

Sign Below:

To check out equipment from the library, you will need to complete this form and provide current identification.
(student identification or a valid picture ID card)