Central Washington University -

QUARTERLY
ALTERNATIVE FORMAT REQUEST FORM

Personal Information
First Name
Last Name
Student ID
Phone Number
Quarter requesting materials for

Please select your preferred file format
First Choice
Second Choice
Other			*Please enter your preferred file format if you do not see it listed in the drop-down menu.

Please enter classes for which you are requesting alternative format

*Important Information*

Request form MUST be filled out and submitted every quarter prior to the deadline (see CDS Calendar).
By default the ATRC will only convert those texts that are "required" for your above listed classes unless specifically requested by you.
Alternatively formatted materials will not be distributed unless you have purchased a "hard copy" version of the text.
You must present your original receipt to the ATRC to receive your alternatively formatted materials.
Copies of your receipt are not acceptable and receipts will not be returned.

I have read and understand the *Important Information*

Contact Information

400 E. University Way
Ellensburg, WA 98926
963-2171
email: dahlberc@cwu.edu

Central Washington University

400 E. University Way, Ellensburg WA 98926

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