Nature to You Loan Program
*** Checkout Form ***
Reservation Number: 1038

Member Details
Tex Kubacki
Mem Expires: Sunday, May 31, 2020
Mem ID: 1164
Loan Details
PickUp: Wednesday, July 24, 2019
Return: Wednesday, August 7, 2019
Created: Wednesday, July 24, 2019

7 Specimens

Specimen Item Number Shelf
Coast Horned Lizard ED-100-0213 13D
Atlas Beetle ED-200-0610 R3
Owl Butterfly ED-200-0150 R20
American Bird Grasshopper ED-200-0269 R8
Belted Kingfisher ED-100-0054 33B
Great Gray Owl ED-100-0615 31D
Bicolored Leaf-nosed Bat ED-100-2028 42B

I, as a member of the Nature to You Loan Program, accept full responsability for all materials described above, while in my possesion, I agree with and accept all pre-existing damage reports as noted on this form. I have received, reviewed, and agree to comply with the Loan Program's "Membership Policy".

Late fee: $2 per specimen, per day.

Signature: __________________________________

Released by: ________________________________

Returned: ___________________________________

Received by: ________________________________

Nature to You Loan
School Year Hours: 2:30-5:30 PM Monday-Friday | Summer Hours: 12:30-3:30 PM Wednesday | Phone: 619.255.0236 |