LOAN AGREEMENT FORM
Forest Entomology and Microbiology Group
Forest and Plant Conservation Research Office
Department of National Parks, Wildlife and Plant Conservation
61 Paholyothin Road, Chatuchak, Bangkok 10900 Thailand
Register number… Date
Name of borrower
Position
Address………………… ……………
Tel. Fax.………………………… E-mail.
Describe experience of taxonomic research
Propose of borrow
I accept the loan conditions attached with the loan agreement form.
Borrower signature Date
For officer use only
Date due for return
Permission by Date
Position
DETAILS OF LOAN SPECIMENS
Refer to registration number
ID Species Order/ Location Date/ Cabinet/ Specimen condition
Family Collector Drawer
Total number of borrowed specimens
Carrying box number
Borrower signature Date
Authorized officer Date
RECOMMENDATION OF BORROWER INSTITUTE
I recommend that loans made by are the joint responsibility of the
institution.
Name Position
Name of institution
Address
Tel. Fax.
E-mail
Signature
Date