Equipment Checkout Form

Would you like to check out a piece of equipment? You will receive an answer from the Athletics staff within a few days. Please provide the following information:

Date needed (mm/dd/year):
Time of day needed (ex. 3:15 p.m.):	select one a.m. p.m.
Your name:
Your email:
Your on-campus extension:	ext.
Items to be checked out:	Agility Ladders Cones Hurdles Jump Ropes Stop Watches Whistles Other
If Other, list here:
How many items needed?
Expected return date (mm/dd/year):
Any additional information you would like to provide?
TODAY'S date:
Your "signature": (Typing in your name will suffice as your signature.)