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Software Loan Form

Test Proctor Form

 

Microsoft Software/RSU Software Loan Agreement For An RSU Applied Technology Course

I the undersigned Rogers State University Department of Applied Technology student or member, by signature on this agreement, promise that I will not share any copy of Microsoft Software loaned to me in the course specified below, with any other person or entity. I further promise to return to RSU any CD containing Microsoft Software loaned to me by RSU, and destroy any other copy of Microsoft software loaned to me in the course (installed on a computer or otherwise), immediately after need for this software with respect to the course.

I understand that violation of this agreement constitutes possible copyright infringement, and may lead to legal action against me and possible loss of my grade in a related course; and that my grade in the corresponding course may be withheld until the software is returned.

NOTE:  Only one software package can be loaned per each agreement!

Name

 

Current Address (Street)

 

Current Address (City/State/ZIP)

 

Current Phone Number

 

Permanent Address (Street) 

 

Permanent Address (City/State/ZIP) 

 

Permanent Phone Number

 

Preferred E-Mail Address

 

Software Package Requested

 

Course Per Software Loan

 

Professor Per Course/Software

 

Expected Software Return Date

 

Signed ________________________________

Date __________________________________ 

Please mail, FAX, or hand-deliver the above to the person indicated at the below, prior to being loaned any related software.  After receipt and approval of the form, a copy of the requested software will be made available to the requesting person, generally within 1 to 2 days, in Herrington Hall 110 on the Claremore, OK campus, or by paper mail.

Cliff Layton
1701 W. Will Rogers Blvd.
Rogers State University
Claremore, OK 74017

Phone:  918-343-7520

FAX:  918-343-7623

Actual Date of Software Return  __________________________________________