STUDENT ALTERNATIVE TEXT REQUEST FORM

Please provide the following books on CD-ROM/cassette tape for my use during Fall / Spring of _____ . I understand that I am required to purchase a print copy of the text and that I may not copy or re-sell the CD-ROM. Cassettes and CD-ROMs must be returned at end of semester. I also understand that I may need to provide a print copy that will need to be cut for scanning (Disability Services office will notify in this case - book will be returned to student re-bound). I have read the Alternative Text Agreement, and I agree to abide by it. My signature here also verifies that I have purchased a copy of the listed books (required).

Signed _____________________________ ID# ___________ Date __________ Phone _______

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Print this form, complete, sign and mail or fax to:

On Campus:
Box 3019

 
Off Campus:
Messiah College Disability Services
Box 3019, One College Ave.
Grantham, PA 17027

Fax:
717.796.5217