TAPED TEXT/ E-TEXT REQUEST FORM

Date _____________

Name_________________________ Address___________________________

Phone ________________________ NU ID or SS #________________________

E-Mail Address __________________________________________________________

Please list the classes that you would like taped/e-text textbooks for:

(To utilize E-text, you must have a computer with a screenreader such as JAWS on it.

Note: If e-text is preferred, SSD will do its best to secure your preference, however it is not guaranteed.)

Please circle one answer:

• Do you have an RFB account?

YES NO

*If no, please fill out the RFB certification form available through the SSD office.

• Do you want tables, graphs and figures found in your text described onto tape?

YES NO

• Do you want lab manuals recorded?

YES NO

• Do you want reference/optional class books recorded?

YES NO

*Late Requests:

Please indicate on your syllabus as to where we should begin reading.