International
Language Resource Center
Missouri Southern State College
LOAN AGREEMENT
| Applicant: |
________________________________________ |
| Position: |
________________________________________ |
| Organization/Dept.: | ________________________________________ |
| Mailing address: | ________________________________________ |
| Daytime phone number: | ________________________________________ |
| Title | Date Needed | Return By (for office use only) |
Returned (for office use only) |
| 1. | |||
| 2. | |||
| 3. | |||
| 4. |
Intent of presentation: ________________________________________________ Size and type of audience expected: _____________________________________ Materials will be [ _ ] mailed or [ _ ] picked up and hand delivered (check one). I hereby apply for the loan of the above stated materials. I agree to the loan terms and conditions prescribed in the Loan Policy, and I will comply with all the instructions specified therein. Signature: _____________________________ Date: _____________________ |
Please send or fax this form to the following address:
International
Language Resource Center
Missouri Southern State College
3950 E. Newman Road
Joplin, MO 64801-1595
Telephone: (417) 625-3109
Fax: (417) 625-9585