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ROBOTICS LABORATORY

BORROWERS FORM
DATE FILED: ______________________ ACTUAL DATE OF USE: _______________________

STATUS
DESCRIPTION QUANTITY BORROWED RETURNED

NAME OF BORROWER : __________________________ COLLEGE/ DEPARTMENT: _______________________


INSTRUCTOR: ______________________________ PURPOSE: _________________________________________

NAME & SIGNATURE OF BORROWER LABORATORY- IN - CHARGE

APPROVED BY:
SENIOR HIGH SCHOOL HEAD

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