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)Date(Required) MM slash DD slash YYYY
