LENDING LIBRARY BOOK LOAN APPLICATION
The purpose of the Lending Library is to assist student who are members of special populations. i.e. Single
Parents, out of workforce individuals, English Learners, and individuals preparing for a non-traditional career
field, including students who have exhausted all educational financial assistance with minimal resources or means
of purchasing textbooks for class. Students must be registered for class(es) and financial aid award information
must have been updated to the students account the semester Lending Library services are requested.
PLEASE FILL IN YOUR INFORMATION:
LAST NAME___________________________ FIRST NAME___________________________ M.I. _________
STUDENT ID___________________________ SEMESTER: Fall Spring Summer YR.: 2020
PROGRAM OF STUDY _____________________ DIPLOMA DEGREE CERTIFICATE
MAILING ADDRESS _________________________CITY____________________STATE______ZIP__________
PERSONAL EMAIL_________________________________________________________________________
HMPH: ______-______-_________ WKPH: _______-______-_________ CELL PH: _____-______-_________
MARK ALL THAT APPLY (SEE LENDING LIBRARY PROCEDURE FOR EXPLANATION)
SINGLE PARENT
OUT OF WORKFORCE INDIVIDUAL ENGLISH LEARNER
I hereby give my consent for College personnel to access my financial aid records in order to certify my
eligibility.
Book
What course is the book needed for? (i.e. COLL 1040)___________________________
Title of Book: ________________________________________________________
ISBN number on the back of the book:_____________________________________
What course is the book needed for? (i.e. COLL 1040)___________________________
Title of Book: ________________________________________________________
ISBN number on the back of the book:_____________________________________
What course is the book needed for? (i.e. COLL 1040)___________________________
Title of Book: ________________________________________________________
ISBN number on the back of the book:_____________________________________
I agree to return all books in the conditi
on loaned by AUGUST 4, 2020. I understand that I am responsible for books
borrowed and agree to pay STC for a new replacement for books that have not been returned or returned with writing and/or
in poor condition. I certify that the information provided on this application is true and correct to the best of my knowledge.
I fully understand and agree to the terms and conditions of this agreement and that failure to abide by the guidelines in this
agreement may prevent future use of this service and a hold may be placed on my account preventing registration and
receipt of grades.
Signature _______________________________________________________Date _____________________________
If you are requesting more than 3 books please see back of form.
On which campus do you plan to pick up and return your books? ____ Vidalia
____Swainsboro
