Access / Disability Services - Alternate Text Form

* = Required

General Information

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 other options.

You must provide proof of purchase for all texts requested prior to release of files, whether electronic or on external media. This stipulation is based on copyright law and is a required part of the conversion process.

Texts that do not need special processing will be sent by email to the student immediately upon receipt from the publisher.

Your Information

Full Name

CCA ID

If you do not know your ID#, enter 00000000 (8 zeros)

Email address

Phone number

Birth Date

CCA Student Status

Current Academic Year

This is the year for which you are requesting materials. Example: 1516

Term

This is the term for which you are requesting

Proof of Textbook Purchase

Please attach your textbook receipts here.

You can upload up to three files - to upload more than three files, please add them to a single zip file before uploading.

Upload receipt (Maximum file size 10mb)

Course Information

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.

Course Name

Please provide title and course section number. Example: Animation I, ANIMA-100-01.

Professor's Name

Title, Author(s) or Editor(s), Year/Edition

Please make sure to enter in all information, otherwise your request may not be properly submitted.

Fields for form variables

Contact Information