Request for Specialized Format
Disabled Students Programs and Services
11600 Columbia College Drive Sonora, California 95370
209-588-5130
• Specialized format is for use by students with verified print disabilities.
• Any further reproduction or distribution of this material to anyone is an infringement of copyright law and
individual may lose the ability to request any further books in alternate format.
• Student has legal right to the alternative media only as long as they own the material it was created from.
Student may be in violation of copyright laws if this is not the case.
• Student will supply material to be formatted at students expense.
• Request must be made at least 5 working days before pickup date and time and after receipt of original
requested media. The more complicated the transfer to alternate media, the longer the time required. We
will need to see your course syllabus to determine the timeliness of alternate formats.
• An entire book conversion may not be requested at one time, special circumstances are considered on a case-
by- case basis.
• Make appointments with the Alternate Media Specialist on a regular basis to stay current with timely and
accurate media conversion. Student must return request form to the Alternate Media Specialist.
• Books left with alternative media specialist 30 days beyond end of current semester will be donated to the
college library.
Student ID First Name Last Name
Email Request Date
Semester Course Book Title
Chapters
Type Of Alt Media
Signature Field
Columbia College
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