Policy 101.11a : Personal Use of
University Resources (form)



                UNIVERSITY OF SOUTHERN MAINE

   OFF-CAMPUS USE OF UNIVERSITY ASSETS/EQUIPMENT RELEASE FORM

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  ___________________________         _________________________
       Borrower's Name                  Borrower's Signature

Date of Loan:________________         Length of Loan:__________

Off-Campus Location:___________________________________________
                     (Street)    (City)      (Phone#)


Dean of Executive Officer:_____________________________________
                                   (Signature)

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| EQUIPMENT DESCRIPTION/MANUFACTURER  MODEL#  SERIAL# BAR CODE# |
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PLEASE RETURN TO:PROPERTY MANAGEMENT - 212 CORTHELL HALL - GORHAM

These pages are designed and maintained by
Johann Pretorius HRIS Manager
Human Resources Information Systems
Tel: 780-5628 - Fax: 780-5554 - Email: HRIS
 © 1999 USM - HRIS

University of Southern Maine
A Member of the University of Maine System