Text Conversion Request Form

The following form is to be utilized by students approved for text conversion as indicated on their Student Academic Accommodation Request (SAAR) form. Students must have already completed/signed SAAR forms.

Students must provide ALL of the following information to ensure the correct textbook is converted and in a timely manner. Students will be loaned OCR text on CD for use with Kurzweil (or another text-to-speech tool).

Student Information

Student Name

Student ID

Today's Date

Phone/Email

Please indicate the format you are requesting

TXT File
Kurzweil
MP3

Other (please specify)

Instructor information

Name

Phone

Textbook information

Course & section number

Title of textbook

Edition

ISBN (10 digits)

Authors

Publisher

Additional textbook information

Course & section number

Title of textbook

Edition

ISBN (10 digits)

Authors

Publisher

Additional textbook information

Course & section number

Title of textbook

Edition

ISBN (10 digits)

Authors

Publisher

Please indicate below which option you prefer

Yes, I grant Iowa State University SDR staff permission to remove the binding from my textbook listed above.I understand that my text book will be returned to me rebound as a fully functional spiral bound textbook. Please note that highlighted text, formulas, and/or pictures will not properly be read by the software.
No, I do not grant Iowa State University SDR staff permission to remove the binding of my textbook listed above for the purpose of creating electronic text. SDR will initially attempt to obtain a copy of the textbooks from the publisher, department and/or instructor. However, obtaining a usable and/or timely form of electronic text from the publisher may take 6-10 weeks. Please note that highlighted text, formulas, and/or pictures will not properly be read by the software.

Once submitted, a confirmation email will be sent to you. This email will contain information regarding our next steps.

Thank you for providing this information. Have a great day.

Dean of Students Office

Student Disability Resources

Text Conversion Request Form