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* indicates a required field

Date *

Select a date from the calendar.

Site *


Which site do you want your EOPS services sent to?

Student ID# *


Enter your Shasta College Student ID #.

Last Name *


Enter your last name.

First Name *


Enter your first name.

Address *


Enter your mailing address.

City *


Enter City.

Zip *


Enter Zip.

Units *


Enter # of units currently enrolled.

Email *


Enter your email address.

Home Phone *


Enter Home Phone#. Ex: 530-242-7540

Cell Phone *


Enter Cellular Phone #. Ex: 530-242-7540

Services Requested

Which service(s) do you want sent to your campus?

Calculator/Recorder


If you selected calculator or recorder above, what type do you need? One selection only.

Text Books


Complete this section if you are requesting textbooks from the Lending Library.

Text book requests must have the SUBJECT, TITLE, AUTHOR and EDITION. Example:

ENGL - Models for Writers, Rosa & Eschholz, 11th Edition.
MATH - Beginning & Intermediate Algebra, Martin-Gay, 3rd Edition.

Tips: List the books you need the most (the most expensive or books you do not wish to keep) first.  Requests are not guaranteed, as EOPS Lending Library materials are first come, first served.  You may list all your required textbooks but only TWO will be checked out to you.

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