PLEASE NOTE: This information Must be filled out in front of the technology admin.

Name *
What equipment will you be borrowing? *
Check Out Date *
Check Out Date
Return Date *
Return Date
By checking this box below you agree to following. *
I hereby certify that my name and dates are correct. I also agree to return the equipment back to Hettinger Public SchooI by the date I provided in this form. I understand that by signing out the equipment, I assume responsibility for its condition, and will accept concequences that in the event that the equipment is lost or damaged.
Mr. Janikowski must be present for this and submit his personal password for this agreement to be valid and correct.