Alternate Format Use Agreement

Office of Disability Services --Bethel University

I confirm that I have purchased any books provided to me in alternative formats through the office of Disability Services and that I have the right to use alternate formats of this copyrighted material as an accommodation for a print disability as defined by the Chafee Amendment to the Copyright Act of 1996.

By accepting this agreement, I affirm that I will be using the alternate format of these textbooks, provided to me by Bethel University and/or by the publisher as an accommodation for a disability, for my personal use only and that I will not reproduce, give, or share the alternative formats of the textbooks specified below with any other individual, group, nonprofit, business, or any other entity.  I understand that if I do share these alternate format materials with any unauthorized source, I may be prosecuted for copyright infringement under federal law.

	I accept this agreement
	I do not accept this agreement

Student Name (First, Last)*

Date*