Device Loan Request Form

Step 1: Enter Student Information

Step 2: Pick A Device

Step 3: Confirmation

* = Required Field

Student Information

Only currently registered students can request to loan a device.

Last Name^*

First Name^*

EMPL ID^*

Policy and Agreement

Students loaning devices must adhere to University and college Acceptable Computer Use Policies as well as the following:

You must report any malfunctions and/or damage when it occurs.
Because the equipment may fail, you are responsible for making backups of any files you create. City Tech is not responsible for any data loss.
Equipment must be returned in the same working condition and good order in which it was received.
The equipment can be borrowed for the entirety of the semester. The device loan can be renewed at the end of each semester.
Failure to comply with guidelines and University or College policies may result in denial of current and future privileges to borrow any college equipment and holds on your record.

I have read and agree to the above statements.^*