This document is a sign out sheet for students and teachers to borrow charging device power packs and cords from the school. It records the date, student name, power pack and cord numbers, first and seventh period teachers, and requires the user's initials to agree to return the items by the end of the day and pay to replace anything lost or damaged.

1. Charging​ ​Device​ ​Power​ ​Pack
Student​ ​&​ ​Teacher​ ​Sign​ ​Out
DATE Power
Pack
#​ ​&
Cord?
Last​ ​name First
name
1st​ ​pd
Teacher
7th​ ​pd
Teacher
*Pls
Initial
you
agree!
*​ ​By​ ​signing​ ​out​ ​a​ ​charging​ ​device​ ​power​ ​pack​ ​&​ ​cord​ ​you​ ​agree​ ​to​ ​return​ ​it​ ​by​ ​the​ ​end​ ​of​ ​the​ ​day​ ​(or
sooner!)​ ​and​ ​​ ​to​ ​replace​ ​or​ ​pay​ ​for​ ​it​ ​($12​ ​Amazon​ ​)​ ​or​ ​the​ ​cord​ ​($7​ ​on​ ​Amazon)​ ​​ ​if​ ​they​ ​get​ ​lost​ ​or
damaged.​ ​This​ ​complimentary​ ​service​ ​is​ ​not​ ​for​ ​daily​ ​use​ ​and​ ​we​ ​hope​ ​you​ ​find​ ​it​ ​helpful.​ ​Thanks!