Alternate Text Request Form

Do not fill out this form unless you have been expressly approved for alternate text accommodations through Student Accessibility Services.

Time is of the essence: Please submit this form as quickly as possible. The alternate text may take a month before it is ready.

If you do not prefer to have both a printed text and an alternate text version, for best results, submit this form before purchasing a copy of the book. Depending on what type of alternate text you are requesting, we may be able to direct you to a lower cost option in that format. However, you may need a copy of the book for class before your alternate text is ready. If so and you purchase the book, keep your receipt in case you would like to try to get a refund later.

If you have already purchased the book, upload a copy of the receipt when you submit this form. We may need the purchase information if we are requesting alternate text from the publisher.

To find the required books for your classes, do a search on the Shoreline Community College Bookstore web site. You can also visit the Bookstore in person, located in the PUB (9000) Building, Room 9114. If you are unable to find the information you need, email your instructor and ask for a complete list of required books. Contact the SAS office if you need additional help.

Fill out one form for each book.

Name*

First Name

Last Name

Phone*

Shoreline Email*

Student ctcLInk ID*

Quarter*

Class Name*

Book Title*

Book Author(s)*

Edition*

ISBN Number

Type of Alternate Text*

Audio Braille eBook Hard copy Large Print PDF Word Document

Other:

Have you already purchased a copy of this book?*

Yes No

Where did you purchase this book?

Date book was purchased

Please upload a copy of your receipt.

No File Chosen

File uploads may not work on some mobile devices.

You may upload a photo or scanned image of your receipt. If you received purchase confirmation over email, please forward to sas@shoreline.edu.

Student Name (type)*

First Name

Last Name

Date of Submission*

Typing student name and dating this form connotes signature by student and recognition that they have read and understood above text.

Is anyone else fully or partially paying for this book?*

Yes No

Name of other party fully or partially paying for book:*

DDA DVR L&I Workforce

Other:

Is there anything else you would like to mention?*

16101 Greenwood Ave. North • Shoreline, WA 98133-5696 • (206) 546-4545 • www.shoreline.edu

Shoreline Community College provides equal opportunity in education and employment and does not discriminate on the basis of race, sex, age, color, religion, national origin, marital status, gender, sexual orientation or disability.

The following person has been designated to handle inquiries regarding the non-discrimination policies:

Veronica Zura, Director of Personnel Human Resources and Legal Affairs

(206) 546-7858, vzura@shoreline.edu