Equipment Checkout Form

Equipment Checkout Form
Employee Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please check off each item of SOAR property that you currently have:*

LaptopHotspotLaptop caseBackpackLaptop chargerMouseTabletKeyboardTablet casePrinterTablet chargerFurnitureOther
For each SOAR item you have and listed above, please describe the condition that you received it in (new or used) and its current condition.*
For each SOAR item you have and listed above, please describe which grant/funding source paid for each item to the best of your knowledge. If you don't know, please write "NA". *
By signing below, the employee takes the responsibility for any kind of damage to checked out equipment and acknowledges that the equipment is working properly and in a good condition. For any loss or damage, the employee accepts to cover the cost of new equipment.

The employee also agrees that they will return every item to SOAR on or before the time of their departure from the organization. SOAR reserves the right to remove equipment from an employee's posession at any time.
Signature*

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Date*

MonthDayYear
Date
Should be Empty: