Research Event Equipment: Reservation Form

Scholarship, Research & Sponsored Programs (SRSP)
cjaczynski@brockport.edu

About this Form
- Complete this form to reserve equipment/supplies owned by Scholarship, Research & Sponsored Programs (SRSP) for presentations.
- Please note:
  - • As the recipient of the borrowed equipment/supplies, you will be responsible for returning said equipment/supplies in the same condition in which you received it.
  - • You will be financially responsible for the replacement cost, based on current replacement costs, of any equipment/supplies damaged or lost while in your custody.
  - • A department account number is required on this form in order to borrow equipment/supplies.
  - • It is your responsibility to make arrangements with your department to reimburse the expense to the department if necessary.
- You are expected to pick up and drop off the borrowed equipment/supplies at the SRSP Office.
- All equipment/supplies are to be returned one (1) week after pick up unless other arrangements have been made and approved by the SRSP Office.
- Please indicate in the comments section the date/time you'd like to pick up the equipment/supplies and the date/time you anticipate returning the supplies/equipment.
What's available?

Portable easels, black trifold foam core boards, and binder clips are available for poster presentation events.
Event Name
Event Date Event Date / MM / DD YYYY
Estimated Return? Estimated Return? / MM / DD YYYY
Faculty Name Faculty Name First Last
Email
Phone Phone - ### - ### ####
Department/Office
Billing Name
Should replacement charges be incurred, Account # to Charge?
Requested equipment (Check all that apply)

Requested equipment (Check all that apply) Easels Trifold black foamcore boards Binder clips
Quantity of selected items?
Email (if different from faculty)
Special Requirements:
Contact Crystal Jaczynski with any questions at cjaczynski@brockport.edu or ext. 2523.

Research Event Equipment: Reservation Form

About this Form

What's available?