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IT Equipment Receipt & Agreement
Please complete this form when you are assigned a New Device. Complete this 2x if you have multiple devices (i.e. laptop and monitor)
Name
*
*
Email
*
Date Received
*
Device Model
*
Accessories Received
*
Accessories Received
A
Charger
B
External Mouse
C
External Keyboard
D
External Monitor
E
Headphones
F
USB or HDMI Dongle
Initial Condition
*
Upload Photo
Click to choose a file or drag here
Acceptable Use Agreement
*
I agree to the
IT Equipment Policy
.
Acceptable Use Agreement
Yes, I have reviewed and agree to the policy.
Signature
*
Signature
Submit
