Academic Equipment Requisition Form
Submit your request to borrow or acquire academic equipment for research or educational use.
Full Name
*
First Name
Last Name
Academic Email Address
*
example@example.com
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Department or Academic Unit
*
Please Select
Biology
Chemistry
Physics
Engineering
Mathematics
Computer Science
Social Sciences
Humanities
Other
Your Role
*
Faculty
Staff
Graduate Student
Undergraduate Student
Other
Equipment Requested
*
Laptop
Projector
Microscope
Tablet
Camera
Lab Kit
Other
Quantity Needed (per item)
*
Reason for Request / Intended Use
*
Intended Period of Use
*
Please Select
One Day
One Week
One Month
Full Semester
Other
Supervisor or Approver Name
First Name
Last Name
Supervisor or Approver Email
example@example.com
Preferred Delivery or Pickup Method
*
Pickup from Equipment Office
Delivery to Department
Other
Location Where Equipment Will Be Used
Supporting Documents (if any)
Upload a File
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of
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