Alternate Format Request

Requester and School Information

Name*

First Last

Email Address*

Enter Email Confirm Email

Phone Number*

Position*

School/Institution Name*

School/Institution Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Book Title and Course Information

Book Title, Edition*

ISBN*

Course Name*

Start Date*

End Date*

Assurances

The Electronic File is for use by a student who is currently enrolled in the course listed above.*

I Agree

The student requires an Electronic File to supplement the print version of their textbook.*

I Agree

The student will use the Electronic File solely for his or her own educational purposes.*

I Agree

The school/institution listed above shall take reasonable precautions to ensure that the student does not duplicate or redistribute the Electronic File.*

I Agree

The school/institution listed above hereby acknowledges that the student has provided valid proof of purchase, which clearly indicates that the student -- or the institution, on behalf of the student -- has purchased a new copy of the textbook within a three-month period from the start date of the course listed above.*

I Agree

Waiver Form & Proof of Purchase

Upload your signed Alternate Format Waiver Form*

Please download the waiver form here.

Upload Proof of Purchase

Please note: Proof of purchase must validate that the student -- or the institution, on behalf of the student -- has purchased a new copy of the textbook within a three-month period from the start date of the course for which it is required reading.

Email

This field is for validation purposes and should be left unchanged.