EQUIPMENT CHECKOUT FORM PLEASE NOTE: This information MUST be filled out with a school admin, office secretary, or tech coordinator. Name * First Name Last Name Phone (###) ### #### Grade/Position * Staff Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th What equipment will you be borrowing? * Chromebook PC Laptop Kindle Tablet iPad Projector Camera Chromebook? Type in the number located under the device. (bottom side will have a big white number) What will the equipment be used for? * Return Date (only required for checkouts of multiple days) MM DD YYYY 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. Yes I agree with the terms above. Admin Approval Password * The high school secretary, tech coordinator, or school principal must be present for this and submit their personal password for this agreement to be valid and correct. Thank you! go back to forms page