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Southern Humboldt USD |  3000 |  E  3512  Business and Noninstructional Operations

Equipment Loan Form   

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I assume the responsibility for the following district equipment:

Description ID Number

School-related purpose: (Note: items are not for personal use)

I will return the above equipment to

(administrator or designee)

no later than .

(date)

In borrowing the items listed above, I assume responsibility for any loss of or damage to the equipment or materials. If any items are damaged or lost, I will pay the cost of repairs or replacement.

Signed:

Date:

Approved:

Date:

Exhibit SOUTHERN HUMBOLDT JOINT UNIFIED SCHOOL DISTRICT

version: March 25, 2010 Miranda, California