LAWRENCE UNIVERSITY

COMPUTER LOAN REQUEST FORM

The criteria for the approval of interest-free loans= to benefit eligible staff/faculty for the purchase of a personal computer or related equipment are as follows:

1. = The employee must be a full or part-time benefit eligible member of the faculty/staff of Lawrence University= and purchasing the equipment for personal use in the support of professional activities at Lawrence.

2. The employeeR= 17;s supervisor must attest to the fact that the computer equipment is to be used in a work-related manner.

3. = Final approval for the loan and for meeting the established criteria rests with t= he Executive Vice President.

4. Approved loans a= re available up to $3,000 and may be repaid over 12, 24, or 36 months. &n= bsp; (Minimum payback is $50 per month.) A copy of the vendor’s invoice or signed order form must be prov= ided for approved computer loans.

5. = The employee is legally obligated to pay entire amount of loan. If employee should terminate emplo= yment and not pay balance owed within 30 days of termination, the balance will be subject to a one percent per month (12% annual) late payment penalty. In the event of a default, the university may refer the account to a collection agency and/or initiate leg= al action to recover any outstanding debt.&nb= sp; The employee/former employee is also responsible for the costs of collection including, without limitation, interest, penalties, collection agency fees, court costs and attorney fees.

Description of equipment to be purchased: __________________________________________

_________________________= _____________________________________________________

Intended use/application = to employment situation: _____________________________________

___________________________________________________________________________= ___

Amount of Loan Request ($3,000 maximum): __________________________________= ______

Payback arrangement: &= nbsp; ________ 12 months _______ 24 months ________ 36 months

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Name: __________________________________= ______ LU ID #: ___________________

Signature: ___________________________________________ Date:&n= bsp; __________________

Supervisor’s Signature: _________________________________&nb= sp; Date: __________________

Executive Vice President: __________________________________= _____

NOTE: A COPY OF THE SIGNED ORDER FORM OR INVOICE MUST ACCOMPANY THIS REQUEST.