STUDENT TECHNOLOGY USE AUTHORIZATION FORM

In order to use the IT Media Room equipment (Digital video editing, CD burners and printers), or IT sign out equipment (digital cameras, laptops, projectors, etc.) you will need to send an email request to reservations@albion.edu, or call 517.629.0962. After receiving confirmation for your request you will need to provide the following information when you arrive at the Instructional Technology office located in the Ferguson building.

*Please note-There is also an online sign out request form available at:http://www.albion.edu/it/insttech/signout_request_form.asp.

Please print this form, fill it out and have it signed by your faculty/staff sponsor. Then bring the completed form with you to Instructional Technology when you arrive to use IT equipment.

Student Name:
E-Mail address:
Phone extension:
KC box number:
Project title:
Project Advisor:
Project Duration/date:
Project Description:
Technology needs (what hardware and software do you need to use)
Sponsor Agreement This equipment is intended for College sanctioned use only.  I understand that by authorizing the check out of this equipment my department is responsible for funding any repairs or replacement should damage occur while the device is checked out by the student named above. I will also ensure the equipment is returned at the time and date specified above.   Faculty/Staff Sponsor Signature                                                 date:             Instructional Technologist Signature (if applicable)                                                 date: