Alternate Media Request Form (24-25)

Student Information

For which semester are you making a request? *

Summer 2024

Fall 2024

Spring 2025

Student ID Number *

Example: 900123456

First Name *

Example: John

Last Name *

Example: Doe

Enter your @my.vcccd.edu email address *

Example: john_doe1@my.vcccd.edu

Are you interested in a Bookshare account, which will give you access to a large library of e-texts that you can read on your computer, or on the go with the mobile app? *

Yes

No

Please send me an email with more information