University of California, Irvine



Social Sciences Computing Services4775835-750874005602681321University of California, Irvine150000University of California, IrvineFaculty Travel Laptop Pilot ProgramKit #:[Device Loan-out Date:][Device Return-by Date:]Choose an item.Click or tap to enter a date.Click or tap to enter a date.Inventory of Items Requested/LoanedItemRequested[Loaned]NotesComputing Device & Charger??Carrying Bag (note small/large)??Choose an item.Device Sleeve (instead of bag)??Display/Ports Adapter??Travel Power Adapter??iPad??Remote Desktop Access?Remote access to a UCI computer is neededBorrower InformationName:Click or tap here to enter text.UCINet ID:Click or tap here to enter text.Department Contact:Click or tap here to enter text.Expected Travel Duration:Departure date:Click or tap to enter a date.Return date:Click or tap to enter a date.AgreementThe equipment described above is assigned to the user for the purpose of instruction, demonstration, research, or general University support, directly associated with an authorized University activity.In the event of loss or damage to the equipment while the assignment is in effect, the user in consideration for the assignment of the above equipment agrees to assume total financial responsibility through the means indicated:?Recharge #:Click or tap here to enter text.?Other personal funds-635275948Faculty signature:Date:Upon receiving equipment ................
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