Hard Copy Textbook Request Form

Students enrolled with Sequoia Choice Arizona Distance Learning are provided a digital copy of the textbook for every course in which they are enrolled. Students who have a documented need specified on an IEP or a 504, or a need approved by their school advisor for a specific course, may order hard copy textbooks by completing all fields on this form.

Textbooks are normally shipped within one week to the Arizona address provided on this form.

Your Name & Information

1. Student's Name(required)
2. Your Advisor(required)
3. Your Email(valid email required)
4. Your Contact Phone Number(required)
5. Your Mailing Address
   (Books CANNOT be shipped to a PO Box)(required)
6. Your City(required)
7. State AZ (required)
8. Your Zip Code(required)

Courses for which you are requesting books:

1. Course 1(required)
2. Course 2
3. Course 3
4. Course 4
5. Course 5
6. Course 6
7. I have spoken with my child's advisor and we both agree that these books are needed for my student's school success.

By typing my name below, I commit to returning each book in the condition in which it was sent. I understand that if the books are returned damaged, or not returned within 10 days after the course is completed I will forfeit my $150 educational materials reimbursement.

1. Your Signature(required)
2. Today's Date(required)