Alternative Text Request Form

Enter your first and Last name

Please agree to the following statements:

  • I agree that I have purchased the instructional text for which I have requested an alternative format.
  • I agree that I am enrolled for the semester and the particular course(s) for which I am requesting alternatively formatted materials.
  • I agree that I will not copy or allow anyone else to copy the alternatively formatted materials.
  • I agree that I will not share the alternatively formatted materials with any other party.
  • I understand that any violation of the above statements and of this agreement may constitute a violation of federal and/or state laws and may result in civil or criminal prosecution, payment of fines or other monies to the copyright holder, and/or incarceration.
  • By entering my full name below and submitting this form, I am agreeing to be legally bound by the above agreement.