Nature to You Loan Program
*** Checkout Form ***
Reservation Number: 71

Member Details
Nancy Adams
Mem Expires: Monday, December 2, 2002
Mem ID: 4
Loan Details
PickUp: Friday, June 9, 2017
Return: Thursday, June 22, 2017
Created: Friday, June 30, 2017
Notes: ljlkjklj

3 Specimens

Specimen Item Number Shelf
Sooty Shearwater ED-100-0065 23C
Pacific-slope Flycatcher, Western ED-100-0102 33D
Southern Alligator Lizard ED-100-0004 13D

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 |