DEPARTMENT OF INFORMATION TECHNOLOGY

Computer Tracking Form

Employee # __________________________

Type: PC / Mac (circle one) Model: ______________________________

Computer Name: ______________________ Information Technology Tag: _____________

Serial Number: ________________________ School/Department: ____________________

In consideration of the Buffalo Public School District permitting my use of the above-described equipment at school / work or off district grounds, and intending to be legally bound, I agree to the following:

I acknowledge receipt of the above-mentioned hardware.

I agree to take the necessary precautions to ensure the continued working condition and security of the above-mentioned hardware. In the event of damage / malfunction, I will report this to the District Technology Help Desk.

If the above-mentioned hardware is lost, stolen or vandalized:

I will notify my school principal / department head, I will file a police report, I will copy the police report to my principal / department head, District Security Office and the Information Technology Department.

I agree to return the above-mentioned hardware, complete and in working order:

Upon request of the Department of Information Technology, upon termination of employment with the District, upon transfer within the District in a job area not assigned a computer.

I agree to abide by all software copyright laws and / or The Buffalo Public School District Acceptable Use Policy. I understand that I may not load any software onto my computer not legally licensed by the Buffalo Public School District without the specific permission of the Department of Information Technology.

Name (please print): ______________________________________

Signature: ______________________________________________ Date: _____________________________

(For Office Use Only)

Expected Return Date (If applicable): _________________________

Return Date: ____________________________________________ Return Condition: __________________________

Received by (IT Staff): ____________________________________

Buffalo Public School District / Buffalo, New York July 2004