Alternative Media Proof of Purchase : The University of Akron, Ohio

Alternative Media Proof of Purchase Form

Student Information Name: Phone Number: Semester:

Alternative Media Information Please select which format(s) you are requesting for your alternative media:

Kurzweil
PDF
RTF
Firefly

Course Name and Number: Textbook Name, Author and Edition (If you are submitting proof of purchase for more than one book for the same class, you can list all books together): Course Name and Number: Textbook Name, Author and Edition (If you are submitting proof of purchase for more than one book for the same class, you can list all books together): Course Name and Number: Textbook Name, Author and Edition (If you are submitting proof of purchase for more than one book for the same class, you can list all books together): Course Name and Number: Textbook Name, Author and Edition (If you are submitting proof of purchase for more than one book for the same class, you can list all books together):

Submitted Accommodation Request in STARS Acknowledgement

By checking this box:

I acknowledge, that I have requested alternative media for my courses in STARS before submitting a proof of purchase.

Please upload your receipt for proof of purchase of your textbooks:

An asterisk (*) denotes a required field

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Alternative Media Proof of Purchase Form

By checking this box: