Dept. of Social Work- Laptop Request Form

(For best results, please fill out this form using the Google Chrome Browser.)

For Department of Social Work students only.

Upon completion and verification of this form, a laptop will be checked out to you. If you are on the Alva campus you will receive an email when you are able to pick up in JD 308. If you are on the Woodward or Enid campuses, your laptop will be delivered via campus mail. You will receive an email when it is sent and once it arrives.

Student Name

Required *

Student ID #

Required *

Today's Date

Required *

Cell Phone Number

Required *

Email Address

Please use your @rangers.nwosu.edu address *

Additional Equipment

Please select any additional items you would like to checkout. Wireless Mouse Stylus Headphones

Campus

Select the campus from which you would like to pickup your laptop: *

I certify that this laptop will be used solely for academically-related work. I understand that I am personally responsible for returing this laptop in the condition it is right now. Further, I am finacially responsible ($200) if, for any reason, I am unable to return the laptop in working condition or it is damaged.

Electronic Signature * I understand and agree.