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D'Agents Project Equipment Loan Form

Please send the following information to rapjr@cs.dartmouth.edu to
help us keep track of who has each piece of equipment that is on loan:

                 First Name:
                  Last Name:
              email address:
                     Course:         (if this is for a class project.
                                      For example, CS 23)
 Area Code and Phone Number:
             Street Address:
                       City:
                      State:
                   Zip Code:
                    Country:
            Project/Purpose:

             Equipment Description:
 Equipment number or serial number:

The street address can be your office or dorm address.  If your
address is outside the USA please provide the equivalent
address information for your country.

This information will be stored in the D'Agents Project assets
database and only be used for purposes directly related to the
D'Agents project.  If you would prefer to not have any of your
info in our database, email us and and we will see what we can do.
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