PCC > Academics > Virtual Campus > Faculty/Staff Resources > PDLA Checkout Form

This is a request for: Checking out an item Recheck out an item you already have   Date:     Name:     Email Address:     Department:     Contact Phone:     Which campus do you want the item sent to? Pueblo Fremont Southwest   Employment status: Full-time Faculty Adjunct Faculty Staff   Type of Resource Media checking out: Book CD/DVD Tape   Item Title:     Item Reference Number (see web site for number):     The account number for reimbursement if materials are not returned is:     This number can be obtained from your immediate supervisor or department chair. All Lab Resource materials can be checked out for 3 weeks. This will start the day the media is shipped to another campus. An extension may be filed for by using this same form. Special Notes: