Borrower: ____________________ Toolkit #: ________ David A. Powers Lending Library Assistive Technology Checkout Inventory Sheet Browse through the devices available in our lending library. See an item you like? Click the box to the left of the device to mark it as an item you would like to checkout. *YOU MAY CHECK OUT UP TO 5 ITEMS. STUDENTS What would like included in your kit? AT for Literacy ☐FLY Fusion : Pentop Computer #_____________ Items Included: FLY Fusion Pentop Computer USB Cable, installation guide Games sampler, notebook FAQ/Application reference card FLY through Math Multiplication & Division package FLY through Math interactive MathPad ☐Neo Alphasmart #_____________ Items Included: Neo Alpasmart bag & device USB cable,installation CD Documentation CD User manual, quick guide ☐Tag School Reader #_____________ Items Included: Tag School Reader USB cable Ozzie and Mack activity book #1 Title Varies activity book #2 ☐PenFriend #_____________ Items Included: PenFriend ☐Classmate Reader #_____________ Items Included: Classmate Reader Irene Howell Assistive Technology Center IHAT STAFF --2 staff members (one to verify) Please initial as you put items in the kit STUDENTS --Please check items off before returning your kit IHAT STAFF --Please check items off as kits are returned Borrower: ____________________ ☐SOLO Suite Items Included: *** AT for Communication ☐ Cheap Talk 4 #_____________ Items Included: Cheap Talk 4 Cheap Talk user guide ☐ One by Four Communicator #_____________ Items Included: One by Four Communicator 1 x 4 communicator case & 4 talkers 1 x 4 communicator user guide ☐ GoTalk 9+ #_____________ Items Included: GoTalk 9+ ☐ GoTalk 20+ #_____________ Items Included: GoTalk 20+ ☐ SuperTalker #_____________ Items Included: SuperTalker Irene Howell Assistive Technology Center Toolkit #: ________ Borrower: ____________________ Miscellaneous AT Items ☐Little Step by Step #_____________ Items Included: Little Step by Step device ☐BIG Mack #_____________ Items Included: BIG Mack device ☐All Turn It Spinner #_____________ Items Included: Spinner ☐Jelly Bean Transmitter #_____________ Items Included: Jelly Bean Transmitter ☐Don Johnson – Start To Finish packet #_____________ Items Included: One packet – see list. Please write name of desired packet here: ☐Assisted Living Item Items Included: One assisted living item chosen at random IHAT STAFF: If checked, please write name of assisted living item here: Irene Howell Assistive Technology Center Toolkit #: ________ Borrower: ____________________ Toolkit #: ________ ☐ Headphones Items Included: Headphones -- to be used with FLY Fusion Pentop or Tag School Reader *May not be necessary if you have a pair of ear buds or headphones already IMPORTANT: Upon receipt of these items please take inventory to ensure you’ve received everything that has been checked off on the left. Items may be kept for two (2) weeks. When it is time to return the items to the address below, take another inventory to ensure everything you were issued is being returned. Remember All items must be returned or holds may be placed on Registration until resolved. Shipping is at the cost of the sender. Please return to the address below: Mailing Address: Irene Howell Assistive Technology Center 134 Speight Building East Carolina University Greenville, NC 27858 Irene Howell Assistive Technology Center