Assembly Item Check Out
Please complete the following. Thanks!
Date
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Minutes
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AM/PM Option
Full Name
*
First Name
Last Name
Your Room No.
*
Please enter your Office Room No.
Select the item(s) being checked out:
*
Gregg Reference Manual
Dictionary
Laptop
Key
Other
Control No. (i.e., Service Tag No.; Control No.)
*
Enter N/A if unsure. A prefix of "G-" for Gregg; a prefix of "D-" for Dictionary.
Acknowledgment
I understand that the item(s) provided to me must be returned to the Nevada State Assembly on or before my last day or when directed to do so.
Submit
Should be Empty: