Equipment Return
2025-2026
To be completed jointly by TRiO SSS Staff & Returnee
Name
*
First Name
Last Name
Email
*
Equipment Type
*
Laptop
Calculator
Other
Internal Laptop ID Number
PCC Laptop Tag Number
Laptop Accessories
Case
Charger
Other
Internal Calculator ID Number
Date
*
-
Month
-
Day
Year
Date returned
Additional Comments
Returnee Signature
*
Staff Name
*
First and last name of the staff member assisting
Revised: 08.26.2024
Submit
Submit
Should be Empty: