VIDEOTAPE BORROWER APPLICATION
Name |
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Address |
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| Agency name or Instructor Number |
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| Home Phone | |
| I accept full responsibility for all CDs/DVDs/videotapes I borrow from EMSTAR. I agree to return any borrowed videos promptly, rewound, and in good working condition. I understand that any damaged or lost items may be repaired or replaced by EMSTAR and the cost billed to me and/or my agency. | |
Signature |
Date |
Print out, complete, and mail to EMSTAR, 1058 W Church St., Elmira NY 14905 or fax to 607-732-2661