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Laptop Loan Request Form

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RAPCS Laptop Loan Request Form

Please complete the form below to request a loaner laptop (for school use only). Once your loan request has been processed, you will receive a follow-up email from Ms. L Jones ([email protected]). Thank you.

First and Last Name*

Answer required for "First and Last Name"

RAPCS Email*

Answer required for "RAPCS Email"

Please indicate whether this laptop loan is intended for an RAPCS student or RAPCS Employee.*

Answer required for "Please indicate whether this laptop loan is intended for an RAPCS student or RAPCS Employee."

This loan is intended for an RAPCS student.

This loan is intended for an RAPCS employee.

Please provide a brief explanation of the reason for your laptop loan request.*

Answer required for "Please provide a brief explanation of the reason for your laptop loan request."

If this loan is intended for an RAPCS student, please enter the student's first and last name below. (Write N/A if this is a loan intended for an RAPCS staff member).*

Answer required for "If this loan is intended for an RAPCS student, please enter the student's first and last name below. (Write N/A if this is a loan intended for an RAPCS staff member)."

If this loan is intended for an RAPCS student, please select the student's grade level.*

Answer required for "If this loan is intended for an RAPCS student, please select the student's grade level."

N/A

Please indicate the anticipated start date of the laptop loan.*

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Please indicate the anticipated end date of the laptop loan.*

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Please provide additional details or comments below, if necessary.

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Confirmation Email

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