Inventory Form

Employee _______________________________ School _____________________________

Employee Signature ______________________________________ Room Number _______

Principal Signature _______________________________________ Date _______________

Please indicate the number of items in the room:

_____Student Desks _____Television(s) Workroom Equipment

_____Teacher Desks _____Carts _____Copier(s)

_____Student Chairs _____Library Chairs _____Paper Cutter(s)

_____Teacher Chairs _____Library Tables _____Printer(s)

_____Computers _____Cafeteria Tables _____Shredder(s)

_____Printers _____Cafeteria Chairs

_____Computer Tables _____Bookcases – Not Built-Ins

_____File Cabinets _____Tables

Other Audio/Visual Equipment -- Please list:

_______________________ _______________________ _______________________

Is there any item in your room that you consider to have a value of more than $5000? List below. (Examples: kitchen equipment, video editing equipment, wheelchair lifts, etc.)

______________________ _______________________ _______________________

______________________ _______________________ ______________________

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