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Alternative Textbook Request Form

I understand that I am required to purchase the textbook before I can borrow an alternative textbook. It is a violation of Federal Law and Disability Support Services policy for students to share, duplicate, upload or distribute alternative text media. I also understand that doing so may result in the loss of the alternative textbook accommodation and/or legal action.

If you have any questions about this form, please contact

Becky Allington at (616) 234-3597 or

Personal Information
First and Last Name
Your Student ID Number should contain 7 numbers. preferred
Please use a current, working phone number.
Counseling Information
Please tell us the name of the counselor who referred you to this form
Course Information
If you have already purchased your textbooks, you can upload a copy of your receipt here.
Requested Titles