Authorisation Request Form for Evaluation through Added Dimension

All fields must be completed. Failure to do so will result in request being rejected

 _{Please indicate if you require a part shipment on multiple units.}

_{For each part shipment delivery there will be a separate loan agreement form.}

_{Please make customers aware of this before requesting a part shipment.}

_{Please be advised} 

• _{Evaluations are to be kept to a 2 week standard loan, except on prior agreement with Zoe Thomas.}

• _{Any extension of evaluation loans must be discussed and agreed by Zoe Thomas before any agreement with the customer is made.}

• _{In the event of evaluation equipment not being returned within the agreed loan period, it is the responsibility of the Fujitsu Salesperson to chase the return of ALL evaluation equipment. Failure to return the kit within a 2 month deadline will affect future loan requests.}