| Student Contact Information |
| Semester/Year |
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| First Name: |
Last Name: |
| FSU email: |
Phone Number: |
| Use this box to comment on any thing you think we need to know |
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When requested material becomes available, the SDRC will contact me via the email I provided above, giving me specific instructions on how to access the material.
I am responsible for contacting SDRC if any of my contact information changes.
I am also responsible for immediately notifying SDRC if I drop a class, and I will return the material immediately. If this is not done, all subsequent requests will be moved to the back of the queue.
You must be registered for the class for which you are requesting alternative text.
I confirm that I am registered for the classes for which I am requesting alternative text.
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| Course Information |
| Course number: |
Course Section: |
| Instructor Name: |
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| Text Information |
| Title of Book: |
ISBN number:
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| Author: |
Publisher:
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| Edition of Book: |
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| Preferred Format- The Student Disability Resource Center will attempt to obtain the alternate format of the text, based on available options: |
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Word 2003
PDF
mp3
RTF
TXT
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Class Syllabi and Receipts
Class Syllabi and receipts are required. If you do not have your syllabus or receipts yet, you can still make this request so that we can get an early start processing your request. You can elect to either scan your receipts and email them as an attachment (send to plester@fsu.edu) or bring them into the SDRC. You can do the same for your syllabi. Please check the following:
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| Please indicate whether you are going to email your syllabi or bring them into the SDRC by checking only one of the following checkboxes: |
| Syllabi emailed
Syllabi brought to SDRC |
| Please indicate whether you are going to email your receipts or bring them into the SDRC by checking only one of the following checkboxes: |
| Receipts emailed
Receipts brought to SDRC |
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Because this process takes time, it is critical to plan ahead. The sooner the request is submitted with all required materials (receipts and syllabi) provided, the sooner the request will be filled.
I understand that this accommodation is based on the documentation SDRC has on file, and it is provided on a first come, first serve basis. My submission of this form indicates that I have read all the information above and I agree to abide by all stated expectations. I understand that the material is the property of the University and MUST be deleted from my computer at the end of the semester. Failure to do so will result in charges being brought against me.
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