Assistive Technology Loan Agreement

Assistive Technology is loaned to students with disabilities to ensure appropriate accommodations are available for the classroom. The following is an excerpt from an Assistive Technology Loan agreement. This is an example of what a student signs to borrow assistive technology.

I agree to use this equipment solely for the benefit of my education at the University of Arkansas Community College at Batesville (UACCB). I will return the equipment and all accessories provided by Access & Testing Services to the UACCB Access & Testing Services office on or before _________ or on the day I withdraw from UACCB if I withdraw from classes before the date listed in this agreement.

Further, I acknowledge that I am responsible for this equipment. I will exercise extreme care with this equipment including securing the equipment whether in use or not, on or off campus. I understand that I am responsible for any damage to the equipment and if I knowingly harm the equipment or let harm occur, I will be subject to actual replacement costs of the equipment (approximately $xxx). Additionally, I understand that I may be billed the replacement costs of the equipment, and the charges will be placed on my UACCB student account if I fail to return the equipment in its original condition (excluding ordinary wear and any repairs covered by warranty) or fail to immediately report to Access & Testing Services any damage having occurred to the equipment. For the purpose of this agreement, damage to the equipment is defined as damage to the equipment, equipment case, or equipment cords that result in a loss of value in the equipment. This may be cosmetic or functional.

If the equipment is stolen, I will report the theft to Access & Testing Services at the time the theft occurred and provide Access & Testing Services with a police report documenting the theft of the equipment. I acknowledge that I will also be billed for the replacement costs of the equipment if I fail to report the theft of the equipment in a timely manner and fail to provide a police report.

I understand that Access & Testing Services reserves the right to place a hold on my account, preventing me from registering for future classes and obtaining my transcripts if I fail to return the equipment or pay the replacement costs. I may also lose the privilege the borrow equipment in the future.

NOTE: Students under the age of 18 must have an adult sign this statement of responsibility. This includes concurrent students.