DRC Alternate Text Agreement and Order Form

Your Name:*

First NameLast Name

NSHE ID (Student ID Number):

Phone Number:*

Please enter a valid phone number.Format: 000-000-0000.

Email:*

example@mail.tmcc.edu

E-Text: AdobeE-Text: WordLarge PrintOther

Class Name, Number and Section:*

Example: ENG 103 1001

Book Title:*

Edition:*

Author:*

ISBN:*

Publisher:*

By pressing submit, I verify that I understand the following:

I may only request books that are required for the class I am enrolled in.
I am required to submit my book request 3 weeks prior to the start of each semester to ensure I receive the materials in a timely manner.
I am required to provide proof of purchase in order to receive the materials.
That I will use the electronic copy of the instructional material solely for my educational purposes and that I will not duplicate the materials for use by others.
To return or erase any “Alternate Text” materials that are assigned to me, furnished through the DRC.
Submission of this form will serve as a book request and acknowledge that I have read the Alternate Text Policy and each of the statements herein and agree to adhere to the policies set forth.

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