Lyons

Central

School

District

Loan

of District Technology

Equipment

In an

effort to promote

technology

skill development

among

district faculty and

staff,

employees

of LCSD are

allowed

to borrow

district­owned

equipment

during

extended

vacations.

It is necessary

however,

that such

loans

be

on

record

and

that

equipment

be

returned

either

at the

end

of the

vacation

or upon

request

of someone

from the

Media

Department.

Note: Digital cameras

have

a

two­week

loan

period

on this equipment

unless

someone

else

makes

a special

request.

It is also

understood

that

the

equipment

will be

returned

in the

same

working condition

in

which it was

borrowed,

allowing

for reasonable

"wear

and

tear"

due

to normal

use. The

borrower

assumes

responsibility

for any

loss

or damage

beyond

reasonable

use.

Staff

Responsible

for equipment:

,,",

Name:

Grade

& Room

Number:

~'3!i4

t~C"""

Address:

Phone

(Home):

Il~

Equipment

Type:

Please

Check

?J~I]

Laptop

­

Digital Camera

Digital Camcorder

,",'

I

Date Taking Equipment:

Date Expected

to return equipment

Please

state

in writing on

the

back

of this

form your

purpose,

goal,

project,

or research

reasons

with using

this equipment.

Evidence

of increased

use

of technology

in the

classroom

will be

required.

I will be

personally

be

financially

responsible

for equipment

replacement

if broken,

stolen

or lost.

Signature

of Staff

Taking

Equipment

Todays

Date

Approved:

Building Principal

Date

Equipment:

Model

#

Serial

Number

Procedure:

Complete

this form, state

reason

for request

on

back

of form, please

return

to library

media

staff or computer

staff or main

office.