Equipment Loan User Agreement

This form is required to be filled in prior to equipment loan requests.

All loans are at the discretion of the Ecology Lab manager. Improper or dangerous use of any equipment can result in privileges being revoked.

Information and privacy: questions regarding the collection of information on this form can be directed to the form administrator.

First Name: * (required)

Last Name: * (required)

WatIAM Username: * (required)

Student ID: * (required)

Phone Number: * (required)

UWaterloo Email Address: * (required)

Study Area: * (required)

The description of site where the equipment will be used.

Location of Study Area: * (required)

The location(s) where the equipment will be used for the duration of equipment loan. If location(s) are on campus, include building(s), and room number(s). If location(s) are in the field, provide GPS coordinates. If location is home use, include full street address.

Will anyone else be using this equipment during this loan? * (required)

Yes

Other Users

How many other users? * (required)

User 1

Full Name: * (required)

Email: * (required)

User 2

Full Name: * (required)

Email: * (required)

User 3

Full Name: * (required)

Email: * (required)

User 4

Full Name: * (required)

Email: * (required)

User 5

Full Name: * (required)

Email: * (required)

Proof of Completion: "Return to Campus Safety during COVID-19" (SO 2036) * (required)

Files must be less than 25 MB.
Allowed file types: gif jpg jpeg png pdf.

Research Plan or Letter of Authorization (required if conducting graduate work):

Files must be less than 25 MB.
Allowed file types: gif jpg jpeg png pdf.

Other comments and if course related, please write course number and instructor, along with short description of your activities:

Agreement

By submitting this form:

I agree that all the information provided is correct and accurately depicts the usage of equipment.
I agree that I am responsible for the safe handling of borrowed equipment according to University of Waterloo COVID-19 handling procedures.
I agree to disinfect equipment, according to the Ecology Lab disinfection protocol, after every use and between uses by different individuals.
I agree to inform the Ecology Lab manager if the equipment has been in contact with or stored in the same location as an individual who is experiencing COVID-19 symptoms.

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