Laptop Loaner Request Form

For further inquiries, contact ORU IT at helpdesk@our.edu or call 918.495.6315

Name Name First Last
Email
Department
Work Phone Work Phone - ### - ### ####
Personal Phone Personal Phone - ### - ### ####
Purpose of loaner
How long do you need the loaner (e.g. 1 week?)
Date of pickup Date of pickup / MM / DD YYYY
Date of return Date of return / MM / DD YYYY
Asset Tag of the loaner laptop (For Official Use Only: IT will fill out this part)
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.