Personal Refrigerator Lending Program Request Form

This program provides nursing students, staff, and faculty with small, apartment-sized personal refrigerators for their offices or workspaces in which to store expressed milk. Refrigerators are available only for on-campus offices or workspaces. Upon completion of the form, you will receive an email from Human Resources within 2 business days. Please note that fridge delivery may take up to a week.

Name*

Email*

Phone Number

Phone

Classification*

Faculty/Staff

Student

95 Number*

Location for Delivery (Building and Room Number)*

Loan Period*

How long do you expect to need your personal refrigerator? We will reach out at the end of this time period to confirm the end of your loan or discuss renewal options.

Other*

Please provide an estimate for the loan period.

Comments

By typing your name below, you verify that you have read, understand, and agree to abide by the following guidelines for use of the Personal Refrigerator Loan Program.*

The refrigerator is to be used for lactation purposes only, not for storing personal food and drink.
Refrigerators are available only for on-campus offices or workspaces.
Damaged or broken refrigerators should be reported immediately to Human Resources at hrinfo@uoregon.edu.
When you are finished with the refrigerator, please defrost and thoroughly clean the unit with bleach-water for the next user. Contact Human Resources at hrinfo@uoregon.edu to arrange a pickup.

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