REACH Book Loan Form

First Name*

Last Name*

Mt. SAC ID Number*

Mt. SAC Email*

Phone Number*

Drivers License/ State ID*

Address*

City*

State*

Zip Code*

Book Request Semester*

Please select which semester you are requesting a book loan

Select

Upload Your Class Schedule

Upload a screenshot of your class schedule in which the books are needed. (Please use .jpg, .jpeg, .gif or .png formatted images.)

Drag and drop files here or

Book Information*

Provide infomation about the book that you are being loaned. State the following - Class, Book Name, Author and Edition, Professor

Are You Receiving Other Financial Aid

Select or enter value

Please CHECKMARK each of the following boxes below to indicate that you have read, understand and agree to the following terms of the Mt. SAC Book Loan Program

Provided Class Schedule*

I understand I will need to provide a copy of my class schedule before receiving the book

Book Return If Class Is Dropped*

I understand I will need to provide a copy of my class schedule before receiving the book

Disqualification From Future Book Loans*

I understand that failure to follow this agreement may disqualify me from future book loans

Active REACH Membership*

I understand that I must be an active REACH student in order to be eligible for the REACH Book Loan Program

Three Unit Minimum*

I understand that I must be enrolled in at least 3 units to be eligible for the REACH book loan program

Select or enter value

Book Return Agreement*

I understand that I must return the book to the REACH program by the following date. (Please select a return date)

Term Acknowledgement*

By checking this box, I acknowledge the terms set above

Send me a copy of my responses

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