Alternative Media Request (2.0)

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Please use this Request Form if you are eligible to have your textbook provided in an alternative format.

You can complete and submit this Alternative Media Request Form via the Internet (online) or via a printed version.

  • To use the Internet (online) version, click on the NEXT button at the bottom of this screen.
  • To use a printed version of this Form, please contact┬áDisability Resource Center at Room 5997 (located between parking lots 5 & 6).
I understand that any electronic text, which may be supplied to me, is solely for my own educational purposes.

I will not copy or distribute any such electronic text in violation of the Copyright Revisions Act of 1976, as amended (17 U.S.C. Sec. 101 et seq.).

I understand that failure to follow this agreement may be a violation of college policy regarding responsible use of Disability Resource Center services.

I understand that a violation of that policy, including improper distribution of electronic text, may result in suspension of Disability Resource Center services for me. *This question is required.