Drexel University
Office of Disability Resources
Alternative Format Request
* All students must register with the Office of Disability Resources before completing this form.
Students must complete this form when requesting books in electronic formats as an accommodation due to a
disability.
All books will be provided to students in CD-Rom format unless doing so does not provide the student with equal
access to their course materials.
Personal Information:
Name
Student ID#
Email
Personal Phone #
Indicate Computer Type:
Mac ___
PC ___
Date
Book Information:
Title
Title
Author
Author
Edition
Edition
ISBN #
ISBN #
Copyright Year
Copyright Year
Publishing Company
Publishing Company
Title
Title
Author
Author
Edition
Edition
ISBN#
ISBN#
Copyright Year
Copyright Year
Publishing Company
Publishing Company
Title
Title
Author
Author
Edition
Edition
ISBN#
ISBN#
Copyright Year
Copyright Year
Publishing Company
Publishing Company
Term