Technology Request Form

By submitting this application, the applicant agrees to the following:

I have read and understood the requirements for the Technology Resources Loan Program under the Technology Resources tab before completing an application.
I have reviewed technology availability under the Available Technology Resources tab before completing an application form.
I am aware technology resources must be picked up and returned in person with an APSU Student ID at the Latino Community Resource Center by the established deadlines.
I will be responsible for returning the technology in the same condition that it was in when I checked it out and I will sign technology back in with an authorized LCRC employee.
I will be responsible for the payment of charges as a result of damages and/or loss of technology.
I am aware that if I return the technology after the due date that I will be banned from utilizing these services for 90 days after the return date. If a pattern of disregard for these rules is displayed, you may be permanently banned from utilizing these services.
I am aware that failure to comply with these requirements will result in a hold on my student account and/or I will be found in violation of the Student Code of Conduct.

Please don't fill out this input box.

I understand and agree with the above requirements.*

Yes.

Name:*

Middle Initial:

Last Name:*

APSU Email:*

Phone Number:*Please provide a phone number that we can use to reach you regarding your rentals.

Select the term you are checking the technology for.*Select one term only.

Name of the class the technology is needed for:*

I understand the technology must be returned by the end of the semester I requested it for. *

Yes.

Technology resource being requested:*

T1- 84 Graphic Calculator