Services for the Blind/Visually Impaired and for Students with Print Disabilities

Books Loan Form for Manitoba K-12 Students

Alternate Format Services (AFS) loans special format materials to teachers for the use of print disabled students in Manitoba classrooms.

All registered borrowers are responsible for the safe and prompt return or replacement of all materials borrowed.

Notes to the Teacher:

1. Use a separate form for each student.
2. Use a separate line for each format (Braille, large print, audio books, e-text) of the same title.
3. Please make sure that each form contains the complete mailing address and all student information.
4. Please save each form submitted to your local computer so that you do not need to enter student information each time you order via the Internet. Please make a print copy for your student file.
5. Materials are loaned without charge for the school year (September - June). Materials may be borrowed and returned at any time during the year.
6. Materials should be ordered whether or not they are listed in the Online Catalogue. AFS may be able to borrow them on your behalf through their many Interlibrary Loan Partners.
7. If you need help in filling out this form, visit Form Help

Student Information

School Division	(required)
School	(required)
School Address
Email Address
Resource Teacher	(required)
Student Name (first, last)	(required)
Grade
	This request is for: N/A Braille User Large Print User		Is your student: Blind/Visually Impaired Physically Disabled Learning &/or Reading Disabled Multi-handicapped Other

 

Item Information

Full Title	(required)
Syst. Key
Author
Publisher
Edition	Copyright Date
ISBN
Date Required	(required)
Format	MP3 Audio Cassettes Braille Large Print E-text Other	If Braille?	N/A Contracted Uncontracted Selected	If "Selected" Contractions Used

 

Item 2 Information

Full Title
Syst. Key
Author
Publisher
Edition	Copyright Date
ISBN
Date Required
Format	MP3 Audio Cassettes Braille Large Print E-text Other	If Braille?	N/A Contracted Uncontracted Selected	If "Selected" Contractions Used

 

Item 3 Information

Full Title
Syst. Key
Author
Publisher
Edition	Copyright Date
ISBN
Date Required
Format	MP3 Audio Cassettes Braille Large Print E-text Other	If Braille?	N/A Contracted Uncontracted Selected	If "Selected" Contractions Used

 

Submit, Reset, Cancel

If there are additional titles you wish to borrow, please make a copy for your file, submit this form, clear it from your screen, fill it out again and submit the next order.

To Online Catalogue | To Forms Index