2017-18 ITC Equipment Checkout Form

2017-18 ITC Equipment Checkout Form
2017-18 ITC Equipment Checkout Form
Name:
Phone:
_
Winthrop Email:
_____________ Winthrop ID Number
COE Faculty/Staff
COE Student
__
Date of Reservation:__ _
/____
/_
All equipment to be used for business purposes only.
I understand that I am responsible for all equipment that is checked out in my name and fully understand and
agree to adhere to the ITC equipment check out policies located on the ITC web site.
I understand these items are my responsibility. I share the responsibility with the ITC Student Workers to check
these items before taking them from the ITC, before bringing them back to the ITC, and when I return them to
the ITC to make sure nothing is missing or damaged. I can use the checklists below to make sure all items are
returned and in good working order. I understand that all bags with many parts also have a laminated card that
illustrates what those pieces look like to help me keep track of them and that this should also be returned with
the equipment at check in.
To Be Picked Up On:
/
/
Signature at check out:
To Be Returned On:
/
Signature at check in:
Date:
/
/
Date:
/
/
/
ITC Staff Only – Complete Below – be sure to include any extra cables or items
EQUIPMENT TYPE AND QUANTITY
INVENTORY NUMBER
(or list as non- inventory item)
Checked out by:_________________________ Date: ______________ # of items______________
Checked in by:__________________________ Date: ______________ # of items______________
Overdue notice:
2 days past due ____/____/____
Date billed to patron account:
5 days past due ____/____/____ 10 days past due ___/____/_____
Amount billed:
_
2017-18 ITC Equipment Checkout Form
Tripod
Laptop/Chromebook
Items
OUT
ITC
IN
ITC
Items
Bag
Laptop
Power Cable
Mouse (circle YES NO)
All accounts are
logged out of by
patron
Tripod
Bag
Boot/ Mounting Plate
Handle
Knobs are working
iPad
Microphone
Receiver
Audio Cable
Wind Screen
Earbuds
Bag
Batteries working
Rechargeable
batteries
Items
Items
OUT
ITC
IN
ITC
Projector- HDMI, VGA, HDMI/VGA
OUT
ITC
IN
ITC
Bag
Projector
Remote
Power Cable
VGA Cable
HDMI Cable
Camcorder is working
Battery is in bag
Battery is charged at
least 90% or can film
for more than 120
minutes
USB Cable
HDMI Cable
Bag
Power Charger
SD Card- Circle Below
Belongs to Student
Belongs to ITC
Video is recording as
an MP4 file
Video is recording at 4
Mbps
Previous videos are
removed from
camera
IN
ITC
OUT
ITC
IN
ITC
PETE Microphone Additional Items
Antenna
Clip on Microphone
Audio adapter
Audio Splitter
Items
OUT
ITC
OUT
ITC
IN
ITC
OUT
ITC
IN
ITC
ITC
IN
ITC
ITC
IN
ITC
Splitter
Audio Cable
Bag
Canon Vixia Camcorder
Items
ITC
Canon or Sony Microphone
iPad
Case
USB cable
Charging Block
All accounts are
logged out of by
patron
Items
OUT
IN
ITC
Swivl
Items
Swivl is working
Marker
Audio Cable
Power Charger
Bag
iPod Touch
iPod charging cable
Acoustic Microphone
Items
OUT
Microphone
Short Audio Cable
Long Audio Cable
Bag
Power cord
Other
Items
OUT
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