PENN WOOD HIGH SCHOOL

RECEIPT FOR SCHOOL TEXTBOOK

Title of Book: ___________________________________________
Book Number: __________________
Date of Issue: ___________________

Condition: NEW

GOOD FAIR

POOR

(circle one)

Student: __________________________________

Home Telephone: _________________

Homeroom Teacher: ______________________

I certify that I have received for loan the above textbook and agree to return the book with fair wear and tear on request of the issuing
teacher or reimburse the school for loss (replacement cost) or damage.

Students Signature: _________________________________________

PENN WOOD HIGH SCHOOL

RECEIPT FOR SCHOOL TEXTBOOK
Title of Book: ___________________________________________
Book Number: __________________
Date of Issue: ___________________

Condition: NEW

GOOD FAIR

POOR

(circle one)

Student: __________________________________

Home Telephone: _________________

Homeroom Teacher: ______________________

I certify that I have received for loan the above textbook and agree to return the book with fair wear and tear on request of the issuing
teacher or reimburse the school for loss (replacement cost) or damage.

Students Signature: _________________________________________

PENN WOOD HIGH SCHOOL

RECEIPT FOR SCHOOL TEXTBOOK
Title of Book: ___________________________________________
Book Number: __________________
Date of Issue: ___________________

Condition: NEW

GOOD FAIR

POOR

(circle one)

Student: __________________________________

Home Telephone: _________________

Homeroom Teacher: ______________________

I certify that I have received for loan the above textbook and agree to return the book with fair wear and tear on request of the issuing
teacher or reimburse the school for loss (replacement cost) or damage.

Students Signature: _________________________________________