Non-Public Textbook Loan Form

Requests received after June 1^st will be filled in the order in which they are received.

Please enter your Unique ID, along with the student’s information below. Then click “Next Page” to check your loan request.

You can only enter one student at a time in the form below.
If you need to request textbooks for additional students, a link will be provided upon successful completion of this form.

To complete your loan request, please read the loan agreement and
authorize the form by checking “I Agree” below.

Note: All fields are required!

School District of Residence:

Non-Public School:

Unique ID:

Parent First Name:

Parent Last Name:

Student First Name:

Student Last Name:

Grade in the Upcoming School Year:

Date of Birth (mm/dd/yyyy):

Home Street Address:

City:

State:

Zip:

Phone:

Email:

Please read and check "I Agree" below:

Terms of Use:

I affirm that I am the parent or legal guardian of the student listed above, who is registered in the non-public school indicated above.

I agree, and it is my intent, to sign this record by clicking "I Agree" below, and by electronically submitting this record to the Capital Region BOCES. I understand that my signing and submitting this record in this fashion is the legal equivalent of having placed my handwritten signature on the submitted record and this affirmation.

I understand and agree that by electronically signing and submitting this record, application is hereby made for the loan of textbook materials from the Capital Region BOCES. I accept the judgment of the school district or their designated representative regarding the eligibility of individual materials for loan. I understand that all books are to be maintained in good condition, and that if damaged or lost, the book(s) will be replaced at my expense. I also understand that the books must be returned to the school district or any official designated as the custodian thereof upon request. If my child should transfer to another school, the books will be returned to the school district or I will make arrangements with Capital Region BOCES for their return.

I Agree (Checking this box signifies your acceptance of the terms of use above.)

The Capital Region BOCES does not discriminate on the basis of race, color, national origin, sex, disability, or age in its employment and admissions.

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