Loaner Contract ApplicationZengar Institute Inc.2022-01-19T12:55:50-05:00 Use the below translator to review and submit the application in your language! LOANER CONTRACT APPLICATION By sending you a loaner contract, Zengar® is ensuring there is a loaner in stock for you. We will keep this loaner reserved for you for 48 hours. To avoid possible delays, please complete the contract prior to the 48 hour deadline. Zengar Institute Inc offers a free loaner service to its PASS members (shipping not included) in an effort to help trainers lower the amount of down time they experience in their practice as a result of equipment needing to be sent in for repair. We do the best we can to ensure we have loaners in stock for this purpose, however loaner stock is limited, so we do count on our trainers to make arrangements for a timely return of the loaner to allow others in the community to have access to this program as needed. To ensure your time with the loaner is used as efficiently as possible, we have set up the following guidelines to follow throughout the process. We ask that you familiarize with this process (see Option A, B or C towards the end of the form depending on what you are borrowing) and adhere to them as closely as possible to insure the loaner program remains a success.ITEMS LOANED:*Please select all applicable. Tablet zAmp The exact item(s), their serial numbers, and their availability will be confirmed and emailed to you after submission and review of this form.EQUIPMENT SPECIFICATION:The Loaned Laptop/Tablet specification (if applicable) may not be exactly the same specification as yours.PLEASE ENTER YOUR NAME* First Last PLEASE ENTER YOUR EMAIL:* PLEASE CONFIRM YOUR SHIPPING ADDRESS:* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country CURRENT LICENSE:* Limited Unlimited If Limited, please indicate the amount of sessions you would like added to loaner from your session bank:* SHIPPING SPEED:*I need the loaner equipment by: MM slash DD slash YYYY Please note that the quicker the equipment is needed, the higher the rate is for shipping. While we will do our best to get item(s) to you by the date/time provided above, we cannot guarantee it as it involves a third party shipper and we have no control over customs if shipped across borders.LOANER RETURN:After you have received your repaired equipment, please ship loaner item(s) back to the following address associated with your location. (Please package the box and send the weight & dimension to shipper to provide the FedEx waybill):PLEASE SELECT YOUR CONTINENT:*Different continents have different loaner return locations. Please select your continent to receive the correct loaner return address for your loan.Select OneAustraliaEuropeNorth America (Canada & the United States of America)Canadian & American Loaner Requests: Zengar Institute Inc. InHouse Solutions 545A Grand Boulevard Ile Perrot, QC, J7V 4X4Australian Loaner Requests: Stephen Phillis Neurofeedback Australia - Phillis Consultancy 4 Alexander Close Strathfieldsaye, Victoria 3551, AUEuropean Loaner Requests: Haagje Nicolien Ruinen Neuro-Insight Schout Offermanstraat 60 L Roermond 6042 XT, NLPLEASE keep all original packaging to return the loaner equipment. Please pack power cord on the underside of the tablet otherwise damage to the tablet screen will occur. Packaging is the responsibility of the shipper. If packaging is accidentally discarded please obtain a proper tablet shipping box or padded shipping box (for zAmps) from any FedEx shipping center. Failure to do so will result in a charge for any damages that occur to the equipment during shipping. Although there is no charge for the loan of this equipment, shipping, shipping insurance charges and any customs fees (if applicable) are the responsibility of the client. Shipping charges will be billed to you after the fact.TIMELY RETURN & EQUIPMENT CONDITION:At the end of the Term, or when this agreement is terminated, you must return the Equipment to us in full, using the return shipping labels included, in first class condition and with anything that belongs with it. It must be insured for the value specified by Zengar Institute Inc in case of shipping loss or damage. Return of all the loaner equipment and peripherals within 5 days of the loan termination date is expected. A daily rental fee of $35 will be incurred to the borrower in the event of a delayed return, if the delay is due to a lack of action on the borrowers part. If the loaned equipment is not returned within 30 days of term, or is returned in poor condition, without peripherals, not working, stolen, lost or damaged, or with any other issue which renders the system unusable for it’s purpose as decided by a Zengar Institute Inc. Customer Service Representative, you will be charged with the costs incurred to replace or repair the Loan equipment and/or any supplied peripherals as deemed fit by Zengar Institute Inc. USE AND MAINTENANCE OF EQUIPMENT:You must keep the Equipment in first class working order, repair and condition (fair wear and tear excepted), follow all the manufacturer’s instructions; and notify Zengar Institute, Inc. immediately if it is damaged, lost or destroyed. You must also keep the Equipment under your control, only allow properly trained people to use it. You must not sell or attempt to sell the Equipment, give possession of it, give any interest in it, or transfer or assign this agreement to any person, make any alteration or addition to the Equipment without our prior written consent.NO LIEN:You must not involve us in any liability or create any lien on the Equipment.LOAN TERMINATION DATE:Your loan termination date will be provided to you in the email sent by our loaner department.OPTIONS FOR LOANBelow you will find three options for a loan process (Option A, Option B, and Option C), please review each option and then make your selection below.OPTION A Steps to follow if having laptop repaired under manufacturer warranty. Open Technical case with Microsoft by following these steps: Visit https://support.microsoft.com/en-ca Click “login” at top right of page and log in using the login information you created when you registered your laptop when you first received it After you are logged in, click on the “Account” button on the top right (icon of a person) Click on “Technical Inquiry” under “My Support” at the bottom left of page Fill out form and submit. Wait to receive email from Asus with next steps. Please Note: A Microsoft email case # will be required if borrowing a laptop. Return signed contract including Microsoft email # to Zengar® ([email protected]). Please note, loaner equipment will not be shipped until after we have received a fully completed loaner contract from you. Zengar® ships loaner to you and sends you tracking information. Within two business days of receiving loaner unit: Send unit to be repaired to Microsoft (according to instructions you will receive by email from Microsoft after opening your technical case). Provide Zengar® with tracking info of #4 and case # supplied by Microsoft. Within one business day of receiving repaired unit, test and log on to a ZenConnect if reinstallation or relicensing is required. Ship loaner unit back to Zengar® within 5 days of loaner termination date, provide Zengar® with tracking # There is a $35 charge per day for any units not returned to Zengar® in that time period if it is due to not following the steps above. This charge will not be applicable if Microsoft needs to keep the system for longer than their usual turn around time. OPTION B Please pack the zAmp securely with adequate padding. Once packaged, you will need to send the dimensions of the box to [email protected]. A PDF attachment of the FedEx waybill will then be sent to you. (Shipping charges are paid by Zengar Institute Inc, both ways.) To ensure efficacy when sending the email, please be sure to: Include your name in the email zAmp # Box dimensions (LxWxH) Include the USB cable with defective zAmp ONLY if the technician has indicated this to you. *Please note that the entire process (ie: shipping & repair time) can range from 10-20 business days. This is not a guarantee, but rather a guideline- If you would like to overnight the zAmp for sending and return, you may choose Priority shipping at your own expense*OPTION CSteps to follow if having laptop repaired locally (not under warranty). Return signed contract to Zengar® ([email protected]). Please note, loaner equipment will not be shipped until after we have received a fully completed loaner contract from you. Zengar® ships loaner to you and sends you tracking information. Within two business days of receiving loaner unit: Take unit in to be repaired locally. Within one business day of receiving repaired unit, test and logon to ZenConnect if reinstallation or relicensing is required. Ship loaner unit back to Zengar® within 5 days of loaner termination date, provide Zengar® with tracking #. There is a $35 charge per day for any units not returned to Zengar® in that time period if it is due to not following the steps above. This charge will not be applicable if repair shop needs to keep the system for longer than anticipated. PLEASE SELECT YOUR OPTION:* Option A Option B Option C Microsoft Case Number:Please provide your Microsoft Case Number. BILLING INFORMATION (SHIPPING CHARGES):After the submission and review of this form you will be contacted by our shipping department. All shipping charges will be billed to you after the completion of the loan. These charges will include shipping for both delivery and return, as well as any applicable fees and taxes. Please Note: A payment link and confirmation email will be sent to you within the next 24 hours.Or, please indicate your FedEx account number if applicable: Signature AgreementSIGNATURE:*Please enter your full name as your signature. Thank you. DATE:*Please enter today's date upon which you have agreed and signed this loaner form application. MM slash DD slash YYYY