Alternative Textbook Request - Boyce

Alternative Text Request Form - Boyce College

Students must submit this form to the Office of Disability Services each semester to request alternative textbooks.

Student Information
First Name*
Last Name*
Student ID*
Six-digit number.
Boyce College Email*
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 alternative textbooks.
Phone
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 scanning texts for conversion. Texts that do not need special processing will be sent by email to the student immediately upon receipt from the publisher. When conversion is completed for any text or group of texts, your file will be sent by email. The Office for Disability Services will place texts on a flash drive by special request. Materials that are prepared for pick up will be available in the Center for Student Success office in Norton 154.
If you need additional assistance before, during, or after the procedure for obtaining alternate format texts, please contact the Manager for Disability Services at disabilityservices@sbts.edu or 502-897-4680.
You must provide proof of purchase for all texts requested prior to release of files, whether electronic or on external media. Students retrieving materials in the office must sign for their release. This stipulation is based on copyright law and is a required part of the conversion process.
Proof of Textbook Purchase
Please scan receipts and attach here. Online receipts may be downloaded into PDF or Word format and attached.
Drop files here or

Max. file size: 8 MB.
What software or equipment will you use to access your alternate-format text?
Do you require special processing of your alternate text?
If you answer yes to this question, please see options available in next question. If your answer is no, please skip the next question.
- Yes
- No
Special Processing Options/Instructions
Please select all that apply. If your processing need is not listed, please select "other" and move to the next question.
- Scan with Kurzweil
- Adobe/PDF Format
- Microsoft Word Format
- Divide by Chapters
- Other
Other Special Processing Instructions
Use this space to request another processing option or provide additional information about your request.
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 #1
Course Number & Title*
Professor's Name*
Please attach a copy of your course syllabus or book list.
Max. file size: 8 MB.
Textbook Information*
Complete information is required in order to fulfill requests. After entering the information for the first book on your syllabus, click the 'plus' sign to add "another row" for your next book(s). If you want to delete the row you just entered, click the 'minus' sign to 'delete the row.' Follow the same process for each course. Click submit at the end of the page when you have finished.
Title Author(s) Editor(s) Publisher Year/ Edition 13-digit ISBN Where Purchased? Price Paid
Course #2
Course Number & Title
Professor's Name
Please attach a copy of your course syllabus or book list.
Max. file size: 8 MB.
Textbook Information

Title Author(s) Editor(s) Publisher Year/ Edition 13-digit ISBN Where Purchased? Price Paid
Course #3
Course Number & Title
Professor's Name
Please attach a copy of your course syllabus or book list.
Max. file size: 8 MB.
Textbook Information

Title Author(s) Editor(s) Publisher Year/ Edition 13-digit ISBN Where Purchased? Price Paid
Course #4
Course Number & Title
Professor's Name
Please attach a copy of your course syllabus or book list.
Max. file size: 8 MB.
Textbook Information
Title Author(s) Editor(s) Publisher Year/ Edition 13-digit ISBN Where Purchased? Price Paid
Course #5
Course Number & Title
Professor's Name
Please attach a copy of your course syllabus or book list.
Max. file size: 8 MB.
Textbook Information

Title Author(s) Editor(s) Publisher Year/ Edition 13-digit ISBN Where Purchased? Price Paid
Course #6
Course Number & Title
Professor's Name
Please attach a copy of your course syllabus or book list.
Max. file size: 8 MB.
Textbook Information

Title Author(s) Editor(s) Publisher Year/ Edition 13-digit ISBN Where Purchased? Price Paid
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Alternative Textbook Request – Boyce

Alternative Text Request Form - Boyce College

Student Information

General Information

Course Information

Course #1

Course #2

Course #3

Course #4

Course #5

Course #6

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Title	Author(s) Editor(s)	Publisher	Year/ Edition	13-digit ISBN	Where Purchased?	Price Paid