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Parent/Student Textbook Request Form 2018-2019
Use this form to checkout textbooks for home use. One form per student only. Please contact Dr. Moreno (Campus Textbook Coordinator -
) with any questions regarding textbooks.
Student Name (Last, First)
Student ID# (Lunch number)
Subject of Textbook you are requesting (Check all that apply)
ELA (English Language Arts
Math (Also available online)
Science (Also available online)
Social Studies (Also available online)
Indicate below additional textbooks not listed above
Books checked out to take home are the responsibility of the student and must be returned in the original shape during the last week of school. Books that are not returned will be charged as a fine to the student's account. If you have any issues with the textbooks, please contact Dr. Moreno (
) immediately so he can assist.
Parent Name (Last, First)
Parent Contact Number
A copy of your responses will be emailed to the address you provided.
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