Student's Name(Required) Parent/Guardian Name if Applicable Please confirm that you have read each statement by checking the box and answering all questions.Computer Check(Required) I confirm that I received a computer from SAC. Type of Equipment(Required) Serial Number(Required) Privilege check(Required) I understand this is a special privilege and cannot be replaced. I am accepting this computer...(Required) As a rental Permanently Return Check(Required) I agree to return the equipment to Student Advocacy Center in the same condition that it was in on the day I rented it. I understand that there is no charge for the rental of the equipment. Return Check(Required) I agree to replace the equipment at my own expense if the equipment is lost or destroyed during my rental period. Return Check(Required) I agree to have the Equipment fixed if the equipment is damaged during my rental period. Untitled(Required) I understand that SAC does not have responsibility in the repair, upkeep or operation of this computer. Signature(Required) Reset signature Signature locked. Reset to sign again Date(Required) MM slash DD slash YYYY
