Loan Request

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Please complete the following to borrow equipment from Housekeeping Services.
*Required Fields

Requestor Information:
Onyen  Defaults Name, Email, Phone and Account
Name*
Email*
Phone
 ?  Chartfield String*
External Charge Code
Building
Location/Room#
When equipment is needed
Delivery Date* Delivery Time*
Pickup Date* Pickup Time*

Items to Borrow Quantity Comments
Tables
Chairs
Trash Cans
Hand Trucks
Dollies
Moving Lifts
Pinch Bars

If you have any additional comments, provide them in the space below: