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Mac/iPad Adapter
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Order Form | Mac/iPad Adapter

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Contact Information

Contact Name *

Contact Phone Number *

Contact Email Address *

Location

Building

Room

Loan Period

Semester Loan

A Semester Loan allows you to keep the equipment for the entire Semester. Select this option if you require an item the entire duration of the Semester.

Pick-up Return Daily

Equipment is picked up day of class and returned after class.

Pick-Up/Return Daily

Date(s) and Time(s)

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Begin DateSelect Date from Calendar

End DateSelect End Date from Calendar

Start TimeActual Start Time of Class

(e.g. 6:20pm)

End TimeActual End Time of Class

Equipment and Services

Mac Adapter

iPad Adapter

Mac Model

Equipment and Services

Special Instructions

This is my personal computer, please remember my information for next time.

Policy: Mac and iPad Adapters must be returned after class.

Please review Classroom Media Services policies.