LIU AT Lending Library Requests
Please complete this form to request an item from the LIU School-Aged Programs AT Lending Library. You MUST let the student's LEA representative know that you are requesting an item to trial from the lending library before making a request. Remember that the student's LEA is financially responsible for any purchased AT that is recommended for a student's IEP after a trial is complete.
Date of Request
Name of Requestor
Requestor's Contact Information (Email, Phone Number)
Student Name (for whom the loan is being requested)
Student's Home District
What type of AT are you requesting (tab names on inventory sheet)
ELA (Reading, Writing)
Never submit passwords through Google Forms.
This form was created inside of Lincoln Intermediate Unit 12.
Terms of Service