The University of Texas-Pan American
Disability Services
April 19, 2014
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Disability Services Office (DS) Alternative Format Request Form

The Disability Services office will provide the alternative format stated in the student's accommodation letters. If a student is requiring an alternative format other than the stated format in the accommodation letters the student will need to submit a request. Student may be asked to provide documentation supporting the new request. All materials will be processed in the order in which they were received.

Please completely fill out all information for each book requested. Incorrect or incomplete information may cause a delay in your request.

I have read and understand the policies and procedures regarding alternative formats established by the Disability Services Office.

DS will make every effort to give the student the format that is preferred, although we cannot always guarantee that your preferred format will be available.

Please choose alternative format preference:

Complete this information for each book:

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