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Student Textbook/Educational Materials Request Form (for Print Disabled K-12 Students)

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    Secondary Tasks

      Please use this form to request materials for NIMAS and Chafee-Eligible blind, visually impaired, physically disabled, or reading disabled K-12 students who qualify under the Chafee provisions of the U. S. Copyright Law.

      Materials can be ordered in the following formats:

      • Braille
      • Large Print
      • Audio Cassette
      • Learning Ally Audio
      • Digital Audio
      • Electronic Text

      Formats available for electronic text include:

      • Braille-Ready Format (BRF)
      • Kurzweil 3000 format (KESI)
      • Text-Based Daisy (*only an option if Nimas or Bookshare files are available)
      • ePub (*only an option if Nimas or Bookshare files are available)

      Please indicate your first and second preference for format for each item.

      Student Information

      Shipping Information

      Do you want all items in the same format?

      First Book/Material Information

      Materials Request #1
      Format: 10/23/2008.

      Second Book/Material Information (if applicable)

      Third Book/Material Information (if applicable)

      Fourth Book/Material Information (if applicable)

      Fifth Book/Material Information (if applicable)

      Sixth Book/Material Information (if applicable)

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