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Computer Inventory Check-Out
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Students Name
✻
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Insurance Plan
✻
Plan A - $64
Plan B - $55
Plan C - No Insurance/Take Home Only
Paperwork Only - Stays at School
Will Buy Insurance Later
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Date Purchased insurance Plan
✻
Month
Month
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Feb
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Year
Year
2022
2023
2024
2025
2026
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Computer Serial Number
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Computer Asset Number
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Charger Number
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Date Checked-Out to Student
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Month
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Feb
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Year
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Year of Graduation
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- Select -
2020
2021
2022
2023
2024
2025
2026
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2032
2033
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Extra Description
