West Academic Disability Request Form

* Denotes required field

General Information - Requestor Information
Note: If your school is not listed, type your school name in the Other box below.
General Information - Client Information

General Information - Book Details

Book Purchase Verification
To verify the purchase of your book you must upload your sales receipt file(s).
Do not upload files larger than 25MB.

To upload multiple files, click the button above and highlight your sales receipt(s).