Graphing Calculator Check-Out Form

Graphing Calculator Check-Out Form
Date*

MonthDayYear
Date
Student Name*

First NameLast Name
PowerSchool Number*
Your student number
Grade Level*
Student Email*
example@example.com
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Student Phone Number*
Please enter a valid phone number.
Check-Out Date

MonthDayYear
Date
Equipment Section
Checking Out*
I have read the following and understand:
- I understand that by borrowing a graphing calculator from University High School, I am responsible for the device.
- I understand that this graphing calculator is on loan from me from University High School and that I will check it back in at the end of the school year.
Should be Empty:

Equipment Section