Textbook Request Form

Textbook Request Form
Student Name:
Student Address:
Name of Public School Student Resides In:
I hereby request the loan of textbooks in the name of: (Name of Student)
Name of Student:
I authorize (type Non-Public School below) to act on behalf of this student in identifying and ordering books loaned to the student identified above and residing in the district above. The student must maintain each book received in good condition. If a book is damaged or lost the student will be responsible for replacing the book as new.
Non-Public School Name
ParentGuardian Signature

Clear
Date

MonthDayYear
Date
This form is to be kept on file in the individual non-public school for the duration of enrollment.
Should be Empty: