Equipment Checkout Request – PDC Services Portal

Name*
First Last
Department
Email*
Phone*
Extension (if applicable)
Date of Checkout*
Date Format: MM slash DD slash YYYY
Time*

: HH

MM
Computer Request*
Select the type of laptop that you'd like to check out.
- Laptop Windows
- Laptop Mac
Other Equipment (optional)
Check any additional equipment that you need to check out.
- Camera
- Tripod
- Projector
- Microphone
- Electrical
Comments (Optional)
CAPTCHA