This is the year for which you are requesting materials. Example: 1516
This is the term for which you are requesting alternative textbooks.
Upon submission of complete information, you will be contacted by email for any questions we may have regarding your request. If a text in an alternative format is not available, you will be contacted to discuss scanning texts for conversion. Texts that do not need special processing will be sent by email to the student immediately upon receipt from the publisher. When conversion is completed for any text or group of texts, your file will be sent by email. The Office for Disability Services will place texts on a flash drive by special request. Materials that are prepared for pick up will be available in the Center for Student Success office in Norton 154.
If you need additional assistance before, during, or after the procedure for obtaining alternate format texts, please contact the Manager for Disability Services at firstname.lastname@example.org or 502-897-4680.
You must provide proof of purchase for all texts requested prior to release of files, whether electronic or on external media. Students retrieving materials in the office must sign for their release. This stipulation is based on copyright law and is a required part of the conversion process.
Please scan receipts and attach here. Online receipts may be downloaded into PDF or Word format and attached.
If you answer yes to this question, please see options available in next question. If your answer is no, please skip the next question.
Please select all that apply. If your processing need is not listed, please select "other" and move to the next question.
Use this space to request another processing option or provide additional information about your request.
Please fill out the following information for each course you are taking this semester. These items are required by the publisher in order to fulfill requests. Please click the submit button when you have entered requests for your last course.
Complete information is required in order to fulfill requests. After entering the information for the first book on your syllabus, click the 'plus' sign to add "another row" for your next book(s). If you want to delete the row you just entered, click the 'minus' sign to 'delete the row.' Follow the same process for each course. Click submit at the end of the page when you have finished.