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Alternative Textbook Request Form

I understand that I am required to purchase the textbook before I can borrow an alternative textbook. It is a violation of federal and state copyright law, the GRCC Student Code of Conduct, and the policies and procedures of GRCC Disability Support Services for students to share, duplicate, upload or distribute alternative text media. I also understand that if I am found to have violated any of these laws or policies, I may be subject to criminal legal action and/or the GRCC Student Code of Conduct process.

If you would like all of your textbooks in the same format, there is no need to list the titles. Just click on your preferred format in the Title 1 Format Requested spot on the form. If you would like them in different formats, please list the titles individually.

We will contact you when your textbooks are in.

If you have any questions about this form, please contact Jessica Blandford at (616) 234-3597 or


Personal Information
First and Last Name
Your Student ID Number should contain 7 numbers.
Please use a current, working phone number.
Counseling Information
Counseling Contact
Please tell us the name of the counselor who referred you to this form
Course Information
If you have already purchased your textbooks, you can upload a copy of your receipt here. If you haven't, please be sure to bring either the textbooks or a copy of the receipt showing that you've purchased them when you come to pick them up.
One file only.
2 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx.
Requested Titles
If you are requesting a textbook that comes in a bundle, please indicate ISBNs separately. If you would only like certain textbooks in alternate format, indicate so here, otherwise we will provide all textbooks. You can also choose to have different textbooks in different format below.
Title 1 Format Requested
Title 2 Format Requested
Title 3 Format Requested
Title 4 Format Requested
How would you like to receive your e-texts?