TEXTBOOK INSPECTION FORM
DATE _______________ TEACHER NAME __________________PERIOD: _______________
STUDENT ID#: __________________STUDENT NAME _______________________________
TEXT TITLE: ___________________________________________ BARCODE #: __________
INSTRUCTIONS:
¨ Form must be returned the day following receipt of the textbook, with parent signature (required)
¨ Students are responsible for the care and whereabouts of ALL textbooks checked out to them
¨ To avoid being charged for previous damage: make sure you are specific about the damage.
¨ Include
all bent corners, cardboard showing, spine damage, binding damage, torn
pages, indelible or permanent dirt and/or ink marks, outside and inside
condition etc.
¨ Examples:
Pages 1-15 stained; Page 176 torn and taped; Page 44 erased pencil
marks; Pages 234-249 folded; front cover top corners bent; binding
loose; top of spine bent/cardboard showing; corners reinforced with tape
¨ Use back of form if necessary
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Parent/Guardian signature: _________________________________ Date: _____________
Student signature:_________________________________________Date: ____________
A copy of the Morongo Unified School District Textbook Policy #6161 2(a) is available in the school library.
SUMMARY OF POLICY
¨ Students are responsible for textbooks and must pay for damages and/or value of the book
¨ Textbooks must be covered and checked by teachers
¨ Students or parents or guardians will be notified of any damages or charges
¨ A student’s grade report and transcripts may be withheld until books are returned and/or charges paid.
DAMAGE CHARGES
Tears, rips, taped pages, stains, writing, pencil erasers, white, out etc…......…………$0.25 per page
Book rebinding for torn, damaged or separated cover, or spine or broken binding....$15.00 per book
Lost or books damaged beyond repair, including water damage…………..……....Full Value of Book
This form will be kept on file, and compared with the textbook at the time of textbook check-in.