Alternative Format Textbook Request Form
Student Name
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First Name
Last Name
UC ID (M#)
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UC Email Address
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Class & Section Number
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Class
Section Number
Title of Publication
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Please include subtitles, if applicable.
Edition
If no edition is listed, leave blank.
ISBN
*
The ISBN is a 13-digit number that can be found on the copyright page of a book, listed on the course syllabus, and on booksellers' websites.
Select the level of access you are requesting for alternative format.
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1: Digital copy of book (may not be compatible with assistive technology)
2: Documents with searchable text (compatible with text-to-speech or EPUB readers)
3: Screen-reader compatible files (compatible with JAWS and NVDA)
Other (please specify)
How do you plan to use the requested alternative format?
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Listen to it being read aloud to me
Highlight/annotate content
Print content
Other (please specify)
File Uploads
No materials can be released until we receive a proof of purchase/rental/possession for the requested title.
Upload a Proof of Purchase
Browse Files
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Choose a file
The receipt or rental/loan agreement must match the requested book. If you are unable to include this with your request, leave a note in the "Share more details" box below (e.g., "course fee included cost of book").
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Upload the Course Syllabus
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The syllabus should confirm that the requested book is required or recommended for completion of a course in which you are currently enrolled. If you are unable to include this with your request, leave a note in the "Share more details" box below (e.g. "I don't have access to a syllabus yet").
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Course Reading Schedule
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Drag and drop files here
Choose a file
Please provide a copy of the course reading schedule if it is not included in your syllabus. If you are unable to include this with your request, leave a note in the "Share more details" box below (e.g. "I don't have access to a reading schedule yet").
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Tell us about your technology
Any information you can provide will assist our team in effectively responding to your requests.
Which text-to-speech tools do you use to read course materials? (Select all that apply. Please share tool names below in "Share more details" box.)
Browser extensions/plugins
EPUB or eBook reader apps (Dolphin EasyReader, Kindle, Nook)
Text-to-Speech tools (NaturalReader, Speechify, Balabolka, Microsoft Read Aloud)
Textbooks with built-in reader platforms (RedShelf, VitalSource)
Voiceover
Windows Narrator
None
Other (please specify)
What other assistive technology do you use to access course materials and complete coursework? (Select all that apply. Please share tool names below in "Share more details" box.)
Browser extensions/plugins
Canvas Alternative Formats downloads
Display color inversion or filters; dark mode/themes
Magnification software (e.g., ZoomText, MAGic)
Reading & writing support tools (e.g., Read & Write, Kurzweil 3000)
Screen Reader software (e.g., NVDA, JAWS)
Voice to Text/Voice Command
Windows Magnifier
None
Other (please specify)
Which operating system(s) are on the devices you use to access your textbooks and course materials? (Select all that apply.)
Android
iOS
Mac
Windows
Other (please specify)
Share more details about your request.
Share any information that will help us fulfill the request. Examples: details about your current access to the requested book, specific programs/apps you use to read books, barriers you have encountered with the book.
Check the box below to acknowledge the Terms of Use for this service.
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