Educational Opportunity Program
Online Laptop Reservation
You must be a current EOP student.
You must submit this completed form to your counselor/advisor for approval.
You must currently be enrolled at least half time.
You can not have been placed on probation for violation of our policy.
Laptops are given out on a first come, first serve basis.
Laptops are loaned for ONLY 1 week.
You are notified via email, then phone and given 72 hours to pick up the laptop.
Notifications which are not fulfilled will be vacated and next person is served.
It is your responsibility to notify us of any changes in your contact information.
Any violation of the acceptable use policy might lead to probation or loss of privileges.
In the event of loss/damage/theft to the unit, a replacement fee will be assessed.
You must accept the above regulations before continuing.
First Name :
Middle Name :
Last Name :
Mailing Address :
Zip Code :
: Phone Number
: Cell Phone Number
: Fax Number
: Pager/Message Number
: Email Address
: Alternate Email Address
Counselor Name :
No Counselor Yet
: Grade Level
: Enrollment Status
: Advisement Date
Have you checked out a laptop before ?
Have you ever been placed on probation ?
Please explain your need for the laptop :
* Denoted fields are required.