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Woodlake Unified School District |  E  3512  Business and Noninstructional Operations

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EQUIPMENT LOAN FORM

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 _______________________.

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: _________________

WOODLAKE UNION SCHOOL DISTRICT

Exhibit WOODLAKE UNION HIGH SCHOOL DISTRICT

version: April 15, 1998 Woodlake, California