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Alternative Media Request (2.0)

Copy Right Revision Act

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

  • 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 Disability Resource Center in Building #5400 (located near parking lots 5 or 6) or 650-949-7017.
This is a contract stating the following:

I, the undersigned, hereby certify that:
  1. If I am required to show proof of ownership of the textbook, I have either:
    1. Purchased the textbooks or other materials to be converted
    2. Provided a publically available copy that is legally obtainable
    3. Received the classroom material because it was provided to all Foothill College students at no charge
    4. Shown another form of proof to the Accommodations Coordinator.
  2. I understand that any electronic text, which may be supplied to me, is solely for my own educational purposes.
  3. 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.).
  4. I understand that failure to follow this agreement may be a violation of college policy regarding the responsible use of Disability Resource Center services.
  5. I understand that a violation of that policy, including improper distribution of electronic text, may result in the suspension of Disability Resource Center services for me.
By choosing "yes" or "no" you are electronically signing to the above statements. *This question is required.