Nature to You Loan Program
*** Checkout Form ***
Reservation Number: 966

Member Details
Tex Kubacki
Mem Expires: Sunday, May 31, 2020
Mem ID: 1164
Loan Details
PickUp: Wednesday, June 12, 2019
Return: Wednesday, June 26, 2019
Created: Wednesday, June 12, 2019

7 Specimens

Specimen Item Number Shelf
Juvenile Leopard Skin ED-100-0446 Floor
Tyrannosaurus rex skull (model) ED-100-2046 12C
Gila Monster ED-100-0216 12D
Short-eared Owl ED-100-0209 31B
Beak and Feet #2 ED-600-0033 Kits
Bicolored Leaf-nosed Bat ED-100-2028 42B
Butterfly Mix ED-200-0011 R16

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 |