dis-Ability Access

	Western Piedmont Community College - (828) 438-6000, TDD 438-6066
	1001 Burkemont Avenue, Morganton, NC 28655-4504

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Office of Disability Access

ADA/504 Resources

Am I Qualified for Assistance?

DA Forms -

- Request for Interpreter

- Request for Transcriber

- Request for Adapted Materials

DA Student Rights & Responsibilities

Deaf and Hard-of-Hearing Services

Documentation

Financial Assistance

General Information

Transition to Post-Secondary Education

Transportation and Parking

Types of Service

dis-Ability Access

Request for Adapted/Alternative Materials

Student's Full Name:

Student I.D.

Student's Phone:
(Ex. 828-438-5555)

Student's Email:

Title of Textbook:

Edition:

Author of Textbook:

Textbook ISBN #:

Other Materials:

Date Material Needed:
(Ex. Oct. 1, 2008)

I need to adapt my text (materials) to the following alternative format:

Audio Text

Enlarged Print

Braile

I understand that it is my responsibility to purchase or acquire a standard text print version of these materials. I further understand that altered text require considerable time to produce. Please allow at least six weeks for processing.

Sending this form indicates that you understand the above responsibilities.