REQUEST FOR TEXTBOOK IN ALTERNATE FORMAT

Please fill in all blanks to request a textbook in alternate format.

STUDENT NAME:
STUDENT ID #: CONTACT PHONE:
EMAIL ADDRESS:
SEMESTER NEEDED:

COMPLETE BOOK TITLE:

AUTHOR'S NAME:

ISBN NUMBER (look on the back of the title page of the book):
NOTE: This must be the ISBN number that is inside the book itself. Packages that include the book (such as book + CD or book + study guide)
have a separate ISBN number for the package. Providing that number will result in the order being returned and the book delivery being delayed.

EDITION NUMBER:         COPYRIGHT YEAR:

PUBLISHER:

WHERE WAS BOOK PURCHASED? (e.g. KSU BOOKSTORE, AMAZON, etc.):

NEW OR USED?:         PURCHASE PRICE:
I have purchased this textbook and have a receipt. Yes     No

COURSE NAME/NUMBER (e.g. ENGL 1101):

FACULTY NAME:
    

OTHER INFORMATION ABOUT THIS BOOK REQUEST (optional)

Contact Amy Redd (aredd2@kennesaw.edu) with any problems or concerns.