Cornell Student Disability Services

Alternate Format/E-Text Request Form

This online form is for students who are currently enrolled at Cornell University and are registered with Student Disability Services. If you have not signed up for alternate format text service, please call 607-254-4545 to schedule an appointment with the Document conversion Specialist.

Please allow up to 20 business days to receive E-Text for published material and up to 5 business days for all other material.

If the material you need converted to an accessible format is already in an electronic file, fill out the form below and indicate under "Type of Material" that it is an electronic file. Then email the file(s) to alternatemedia@cornell.edu. Please Note: When bringing or emailing material to the office, please include your NETID.

If you are unable to use the form below, please call Cyrus Hamilton at 607-254-4545.

Only One Title Per Form

Student Information

Cornell NetID

(e.g., WQ386)

Full Name

Course Information - complete fully for first request for each course, then just enter course number for additional requests for same course

Semester

Course Number (e.g. Psych 1101)

4-digit numbers, please

Lec/Sec/Lab Number

Instructor Name

Material Requested - enter fully for each text/course packet, etc.

Type of Material

Title

Author

ISBN (important)

Edition

Purchase Price

Format Desired

Optional Note or Additional Information:

By submitting this form, you agree to the following conditions:

You are registered with Student Disability Services and have been approved for an alternate format accommodation
You are registered this course for the current (or upcoming) semester at Cornell University
You have purchased or own the required material you are requesting here in alternate format
You have signed and will adhere to the Electronic Text Distribution Agreement

Document Conversion Center