Corvallis School district 509J

Central Instructional Media Center

Check Out Request Form
 

Please read the following information before you complete the form!

  • You need to submit this form to check out the CIMC resources which belong to special education.
  • This form will be forwarded to the Assistive Technology Team (ATT) and used to prioritize the resources.
  • After submission, close this form and book your item with bookIt menu.
  • Unless you complete both the approval form and the bookIt option, your request may be denied.
     


DATE : Month Day Year
PERSON MAKING THE REQUEST : First Name Last Name
TELEPHONE :
SCHOOL :
STUDENT'S INITIALS :
ITEM REQUESTED :
STUDENT ON IEP : yes no
STUDENT ON 504 : yes no
COMMENTS :

Contact Us

Phone:
541-757-5923
Fax:
541-757-4589
Address:
510 NW 31st St., Corvallis, Oregon 97330
Staff:

Sharon McMurray, Circulation & Science Kits
cimc@corvallis.k12.or.us

Footer

 RSS Feeds Available