Borrower’s Slip

Reference Number: Item:

Item Detail: No. of Reference Number:

Copies

Borrower’s Name : Last Name First Name Middle Name

Date Borrowed: Date to be Returned: Date Returned:

________________________ ________________________
Borrower’s Signature In – charge’s Signature

Borrower’s Slip
Reference Number: Item:

Item Detail: No. of Reference Number:

Copies
Borrower’s Name : Last Name First Name Middle Name

Date Borrowed: Date to be Returned: Date Returned:

________________________ ________________________
Borrower’s Signature In – charge’s Signature