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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.
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.
Files must be less than 2 MB.
Allowed file types: gif jpg png bmp tif txt pdf doc docx.
Requested Titles
If you are requesting a textbook that comes in a bundle, please indicate ISBN's separately. If you would only like certain textbooks in alternate format, indicate so here, otherwise we will provide all textbooks. You can also choose to have different textbooks in different fomat below.