PLEASE SIGN THE FOLLOWING STATEMENT OF CERTIFICATION:
By typing my name below, I acknowledge the information given by me on this form is accurate and complete to the best of my knowledge. I am a full-time SIU student attending classes on the Carbondale campus and I am in good standing with the University.
I understand that if I do not pick up the equipment assigned to me by the agreed upon day and time, I will potentially forfeit my opportunity for use of the equipment.
I understand that if equipment is not returned by the agreed upon day and time, I will be charged for the equipment and a hold will be placed upon my bursar account. The charge for the laptop will be $1,200.
I understand that equipment loan for one semester does not guarantee availability of equipment for any other semester.