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Equipment Loan Request

Questions marked with a * are required

Contact Information

First Name

Last Name

Phone

Email Address

Institution

Name of Person Picking Up the Item

Pickup Date

Return Date

Which piece of equipment are you interested in borrowing?

Copy Stand - Kaiser R2N CP Image Capturing Set (lights not included) (30 day loan)

Photo Scanner - Epson Perfection V370 Photo Scanner (30 day loan) includes laptop

Photo Scanner - Epson Perfection V600 Photo Scanner (30 day Loan) includes laptop

I am personally responsible for the items loaned to me by the Long Island Library Resources Council. I agree to return all equipment to the Long Island Library Resources Council in the same condition as said item was received. I understand that the equipment had been inspected and certified in good condition by the Long Island Library Resources Council staff. I understand that any damage to borrowed items beyond normal wear is my personal responsibility and that I agree to pay for any repairs to restore the equipment to usable condition. I understand that if the equipment borrowed is not returned or is beyond repair, I am personally responsible to pay the amount required to replace the equipment at the current price of equipment.

Agree

Disagree