Center for Student Progress Disability Services
Request for Taped Books

 
Student Name          Student Patron I.D.  
Telephone                 
Full Class Name       Course Code Cat #
Semester                   Year    Edition ISBN
Name of Text         
Publisher                
Author                    
Year Published                                                         Date of Request 

(Office Use Only)

Ordering Tapes
Employee: ___________________________________  Date Ordered from Company _________________________
Please circle: RFB&D or Cleveland Sight (C.S.)  Contact Person: __________________________________________
Shelf #: _____________________________  Book in stock?  Yes  or No

Tapes Received
Date tapes received in the office:  _________________________ # of Cassettes: __________________________
Date student contacted: _______________________  Employee: ______________________________________
Date student picked up: _______________________  Date student returned tapes ________________________
Date returned to RFB&D or C.S.: ______________  Order # _________________________________________

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I ____________________________________________ have borrowed the above named tapes from CSP Disability Services
                                        (Student's Name)
and agree to return them at the end of:  Spring / Summer / Fall    Semester 200 ___.


____________________________________________                         __________________________
                       (Student's Signature)                                                                                                                (Date)