GIRLGUIDES OF CANADA-GUIDES DU CANADA

NOVA SCOTIA COUNCIL- ARCHIVES COMMITTEE

LENDING REQUEST FORM

Please complete the following and send to:

Archives Committee, Girl Guides of Canada, Nova Scotia Council,

3581 Dutch Village Road, Halifax, NS B3N 2S9

Fax: 902-423-5347, or via email at:

Requests should be received at least 15 days in advance of date materials are to be picked up.

Date: Date Needed:

Name:
Address:
Phone: / Email:

I would like to borrow the following:

Item(s) / Details
Uniform(s)
Uniform(s)
Other Item(s)
Other Item(s)

The Uniforms / items will be used for:

Display: ___ , Will be worn: ___, Other:

Pick up Date: By:

Return Date: Or other arrangement:

Signature of person:

(Indicates acceptance of loan conditions noted below.)

CONDITIONS UNDER WHICH THIS LOAN IS MADE

1. A damage deposit of $25.00 is to be included with this form. The damage deposit will be refunded upon return of all loaned items in good condition and within a maximum of 30 days of the pick-up date (or sooner if possible). Make cheque or money order payable to Girl Guides of Canada and indicate on the envelope Attention: Archives Committee.

2. Any shipping charges or charges related to cleaning, repair or replacement will be billed to the person signing on the reverse side of this form.

3. If the uniforms are to be worn, every effort must be made to ensure they are handled carefully.

4. A tie, belt, etc accompanying a specific uniform must be kept with that uniform.

5. PLEASE TAKE GOOD CARE OF THESE UNIFORMS AND OTHER MATERIALS SO THAT OTHERS MAY WISH TO BORROW THEM AND WE CAN CONTINUE WITH THIS SERVICE.

"We protect and respect your privacy. Your personal information is used only for the purposes stated on or indicated by the form. For complete details, see our Privacy Statement at www.girlguides.ca or contact your provincial/territorial office or the national office for a copy."