Accessible Media Request Form - Spring 2023

Complete this form to submit your request for textbook materials in accessible format for Spring Semester and Winter Intersession 2023. You must be enrolled for classes in order to submit request. Gather your textbook information immediately following enrollment via the Pioneer Bookstore. 

For assistance submitting this form, please contact alternate.media@csueastbay.edu
Student Information



(must contain "@horizon.csueastbay.edu")

Please select the approved format listed on your Determination of Accommodations letter. If you are approved for multiple format(s) or a specific format, please enter that information into the comments section of this form. 
Delivery note: Kurzweil files will be delivered to the Kurzweil Universal Library (private folder). All other format(s) will be delivered via email to your horizon account.

Textbook Information

This form can accept up to 10 individual textbook requests
1st Book Request

Department abbreviation | Course # | Section # (E.g., ENGL 100-01)

Enter full textbook title and edition #. If unavailable, enter the exact text displayed by the Bookstore for your course (e.g., "No textbook required", "course materials are being finalized", "No bookstore supplied materials, see instructor.", "course materials have not been determined")

If no ISBN available (e.g., for course readers) enter "Not available". ISBN can be found in the copyright pages of the book.


(e.g. an older or newer version) We often have previous versions of textbooks available immediately from our inventory.

2nd Book Request

Department abbreviation | Course # | Section # (E.g., ENGL 100-01)

Enter full textbook title and edition #. If unavailable, enter the exact text displayed by the Bookstore for your course (e.g., "No textbook required", "course materials are being finalized", "No bookstore supplied materials, see instructor.", "course materials have not been determined")

If no ISBN available (e.g., for course readers) enter "Not available". ISBN can be found in the copyright pages of the book.


(e.g. an older or newer version) We often have previous versions of textbooks available immediately from our inventory.

3rd Book Request

Department abbreviation | Course # | Section # (E.g., ENGL 100-01)

Enter full textbook title and edition #. If unavailable, enter the exact text displayed by the Bookstore for your course (e.g., "No textbook required", "course materials are being finalized", "No bookstore supplied materials, see instructor.", "course materials have not been determined")

If no ISBN available (e.g., for course readers) enter "Not available". ISBN can be found in the copyright pages of the book.


(e.g. an older or newer version) We often have previous versions of textbooks available immediately from our inventory.

4th Book Request

Department abbreviation | Course # | Section # (E.g., ENGL 100-01)

Enter full textbook title and edition #. If unavailable, enter the exact text displayed by the Bookstore for your course (e.g., "No textbook required", "course materials are being finalized", "No bookstore supplied materials, see instructor.", "course materials have not been determined")

If no ISBN available (e.g., for course readers) enter "Not available". ISBN can be found in the copyright pages of the book.


(e.g. an older or newer version) We often have previous versions of textbooks available immediately from our inventory.

5th Book Request

Department abbreviation | Course # | Section # (E.g., ENGL 100-01)

Enter full textbook title and edition #. If unavailable, enter the exact text displayed by the Bookstore for your course (e.g., "No textbook required", "course materials are being finalized", "No bookstore supplied materials, see instructor.", "course materials have not been determined")

If no ISBN available (e.g., for course readers) enter "Not available". ISBN can be found in the copyright pages of the book.


(e.g. an older or newer version) We often have previous versions of textbooks available immediately from our inventory.

6th Book Request

Department abbreviation | Course # | Section # (E.g., ENGL 100-01)

Enter full textbook title and edition #. If unavailable, enter the exact text displayed by the Bookstore for your course (e.g., "No textbook required", "course materials are being finalized", "No bookstore supplied materials, see instructor.", "course materials have not been determined")

If no ISBN available (e.g., for course readers) enter "Not available". ISBN can be found in the copyright pages of the book.


(e.g. an older or newer version) We often have previous versions of textbooks available immediately from our inventory.

7th Book Request

Department abbreviation | Course # | Section # (E.g., ENGL 100-01)

Enter full textbook title and edition #. If unavailable, enter the exact text displayed by the Bookstore for your course (e.g., "No textbook required", "course materials are being finalized", "No bookstore supplied materials, see instructor.", "course materials have not been determined")

If no ISBN available (e.g., for course readers) enter "Not available". ISBN can be found in the copyright pages of the book.


(e.g. an older or newer version) We often have previous versions of textbooks available immediately from our inventory.

8th Book Request

Department abbreviation | Course # | Section # (E.g., ENGL 100-01)

Enter full textbook title and edition #. If unavailable, enter the exact text displayed by the Bookstore for your course (e.g., "No textbook required", "course materials are being finalized", "No bookstore supplied materials, see instructor.", "course materials have not been determined")

If no ISBN available (e.g., for course readers) enter "Not available". ISBN can be found in the copyright pages of the book.


(e.g. an older or newer version) We often have previous versions of textbooks available immediately from our inventory.

9th Book Request

Department abbreviation | Course # | Section # (E.g., ENGL 100-01)

Enter full textbook title and edition #. If unavailable, enter the exact text displayed by the Bookstore for your course (e.g., "No textbook required", "course materials are being finalized", "No bookstore supplied materials, see instructor.", "course materials have not been determined")

If no ISBN available (e.g., for course readers) enter "Not available". ISBN can be found in the copyright pages of the book.


(e.g. an older or newer version) We often have previous versions of textbooks available immediately from our inventory.

10th Book Request

Department abbreviation | Course # | Section # (E.g., ENGL 100-01)

Enter full textbook title and edition #. If unavailable, enter the exact text displayed by the Bookstore for your course (e.g., "No textbook required", "course materials are being finalized", "No bookstore supplied materials, see instructor.", "course materials have not been determined")

If no ISBN available (e.g., for course readers) enter "Not available". ISBN can be found in the copyright pages of the book.


(e.g. an older or newer version) We often have previous versions of textbooks available immediately from our inventory.

Submit Request

Accessible Media Agreement
Accessibility Services in collaboration with ITS Accessibility provides textbooks in accessible format to students eligible for this service. In order to maintain the integrity of the service offered and comply with the law, indicate your agreement to the following terms:

  • I verify that I am registered with Accessibility Services and enrolled for the specific course(s) for which I am requesting alternatively formatted materials
  • I agree that all alternatively formatted materials are for my own educational use and I will not copy, distribute, reproduce, modify, sell, or share the alternatively formatted materials with any other party.  Improper use of copyrighted materials is illegal.
  • I understand that textbooks must be purchased and proof of purchase must be presented to Accessible Media  in order to receive alternatively formatted files.
  • I understand that I may retain alternatively formatted textbook files so long as I own an original copy of the text. I agree to destroy any alternatively formatted files for which I no longer own the original textbook.
  • I understand that I may need to submit paper materials to Accessible Media for conversions into alternate format. I understand that these materials may be returned in an altered condition. Neither Accessibility Services nor ITS Accessibility are responsible for damage to materials in the conversion process.
  • I understand that Accessible Media provides highest priority to students with low-vision/blindness and that sufficient efforts will be made to complete my request in a timely manner.

Enter your initials to indicate agreement
Comments or considerations for your request?

File Upload (optional)
You can upload your syllabi, schedules or receipts (Note: these documents are not required in order to submit request, however they may be required at a later time to fulfill the request). We will notify you once this request has been submitted what documents you will need to email to alternate.media@csueastbay.edu if you have not uploaded anything to this form.

Max (10MB)