Ieisabvik College Textbook Voucher Form
Last Name First Name Middle Initial Full - Time Part - Time Home Phone Work Phone E-Mail Address
REV - 3/13/2006
Mailing Address/PO Box #
City
State
Zip Code
Financial Aid
Cash (Barrow ONLY) Check or Money Order
Credit Card Collect-On-Delviery (COD)
Student Signature
Date
Credit Card # Cardholder Signature :
Exp. Date :
Student above has $ financial aid available for textbook purchases.
Financial Aid Officer (Amanda Burnell) - to verify available funds
Date
For book titles, and pricing information please call the number listed at the bottom of the form. Books for students in the North Slope Villages, will be shipped to the Village Liaisons on either Fontier Flying or Hageland Aviation to save time & money. However, if you choose to order your books COD, they will be shipped directly to you. COD is not recommended.
Business Office (Melba Cabana-Redito) - to verify payment
Date
All quantities are assumed one each. If you want more than one copy of a certain text you must specify which title(s).
Book ID in IC Database
#
1
Course Dept. & No.
Course Title
Textbook Title OR ISBN #
Price
Signature upon receiving the books
Tel:
(907) 852 - 1815 or in Alaska: 1 (800) 478 - 7337 Ext. 1815 Fax: (907) 852 - 1784 or (907) 852 - 1822; vinera.harsany@tuzzy.org
Total =