College of Education

West Chester University

302 Recitation Hall
West Chester, PA 19383
Call: (610) 436-2321
Fax : (610) 436-3102
Email: kcrouse@wcupa.edu


Equipment Request

(must be faculty or student in an education program)

Location
310 Recitation Hall
610-738-0347

Hours:
8:00 AM - 4:30 PM
See schedule or call for evening hours.

Web reservations must be received at least two days in advance.
Last Name:
First Name:
Student ID:
Email:
Phone:
(Area Code & Number)
Checkout Date:
(mmddyy)
Time Needed:
(hr.: min.)
Return Date:
(mmddyy)
Bldg/Rm Equipment will be used:
Course:
Instructor's Name:


Multi-Items for Classes
Check all that apply - Include how many
1.
#Laptops:
2.
# Laptops:
3. Digital Camcorder Cart -
# Cameras:
# Firewires:
4. Digital Still Cameras -
# Cameras:
# USB Cables:
5. Palm Cart -
# Palms:
6. LCD Projector Cart (Projector and Laptop)
7.
Software Crate - Please Select Category:
 

Single Item for Individual Use
8. PC Laptop 12. Digital Still Camera
9. MAC Laptop 13.
10. Digital Camcorder 14. Portable Screen
11. Analog Camcorder 15. Portable Overhead Projector
16.
17.

Special Instructions/Comments (Such as for after hours pick-up or return)

   
 
I need assistance in setting up/using the equipment.
* Please make arrangements with the FTC prior to scheduled use of equipment. *
I accept responsibility for the equipment borrowed. I will operate the equipment carefully and not leave it unattended. I will also report to FTC any problems encountered during the use of equipment.
 
       


Signature required upon receipt of equipment. ______________________________

FTC Staff Witness _____________________________________ Date:_____________


You will receive a confirmation by e-mail. If you do not, please call 610.738.034