Borrowing Equipment

Name *

First and Last Name

Are you? *

Lawrence University Student or Faculty/Staff

Student

Faculty/Staff

Lawrence Email: *

Phone: *

Project Purpose: *

Project for course; select, then list course information in box below Other purpose

Student Teaching

Music recital or competition

Graduate school application

Other purpose (add information in the field below)

List other/additional purpose OR course information:

Equipment Requested (check all that apply): *

Types of equipment. Call 920-832-6965 with questions.

Please describe other equipment:

Date needed (mm/dd/yy): *

Year

Month

Day

Time you will pick up (hour, a.m./p.m.): *

Hour

:

Minute

am

pm

Return date (mm/dd/yy): *

Year

Month

Day

Time you will return (hour, a.m./p.m.): *

Hour

:

Minute

am

pm

Additional comments:

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