{"id":129,"date":"2023-06-06T23:44:12","date_gmt":"2023-06-06T23:44:12","guid":{"rendered":"https:\/\/ct-prod-wp.taftcollege.edu\/forms\/?page_id=129"},"modified":"2023-08-28T15:49:04","modified_gmt":"2023-08-28T15:49:04","slug":"alternative-media-request","status":"publish","type":"page","link":"https:\/\/ct-prod-wp.taftcollege.edu\/forms\/high-tech-center\/alternative-media-request\/","title":{"rendered":"Alternative Media Request"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column]<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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value=\"\"\/><\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_28' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_28_8\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Step 1<\/h3><\/div><fieldset id=\"field_28_1\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name has_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_28_1'>\n                            \n                            <span id='input_28_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_28_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_28_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_28_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_28_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_28_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            <span id='input_28_1_8_container' class='name_suffix  gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.8' id='input_28_1_8' value=''   aria-required='false'   placeholder='A00000000'  \/>\n                                                    <label for='input_28_1_8' class='gform-field-label gform-field-label--type-sub '>ANumber<\/label>\n                                                <\/span>\n                        <\/div><\/fieldset><div id=\"field_28_2\" class=\"gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_2'>Semester\/Year<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_28_2' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_28_3\" class=\"gfield gfield--type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_3'>Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_28_3' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_28_4\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_28_4_container'>\n                                <span id='input_28_4_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_4' id='input_28_4' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_28_4' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_28_4_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_4_2' id='input_28_4_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_28_4_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_28_5\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you check your e-mail regularly?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_28_5'>\n\t\t\t<div class='gchoice gchoice_28_5_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='Yes'  id='choice_28_5_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_5_0' id='label_28_5_0' class='gform-field-label gform-field-label--type-inline'>Yes<span class=\"radio-button\" role=\"none\">\n\t\t\t\t\t<span class=\"radio-button__center\"><\/span>\n\t\t\t\t<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_5_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_5' type='radio' value='No'  id='choice_28_5_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_5_1' id='label_28_5_1' class='gform-field-label gform-field-label--type-inline'>No<span class=\"radio-button\" role=\"none\">\n\t\t\t\t\t<span class=\"radio-button__center\"><\/span>\n\t\t\t\t<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_28_9\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Step 2<\/h3><\/div><fieldset id=\"field_28_7\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you received alternative media at Taft College before?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_28_7'>\n\t\t\t<div class='gchoice gchoice_28_7_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='Yes'  id='choice_28_7_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_7_0' id='label_28_7_0' class='gform-field-label gform-field-label--type-inline'>Yes<span class=\"radio-button\" role=\"none\">\n\t\t\t\t\t<span class=\"radio-button__center\"><\/span>\n\t\t\t\t<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_7_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_7' type='radio' value='No'  id='choice_28_7_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_7_1' id='label_28_7_1' class='gform-field-label gform-field-label--type-inline'>No<span class=\"radio-button\" role=\"none\">\n\t\t\t\t\t<span class=\"radio-button__center\"><\/span>\n\t\t\t\t<\/span><\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_28_6\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Please make an appointment to meet with the High Tech Access Specialist and continue with step 3.\n<br \/>\n<b>Amar Abbott<\/b><br \/>\nHigh Tech Access Specialist<br \/>\n661-763-7977 (office phone)<br \/>\n661-763-7758 (fax number)<br \/>\nAabbott@Taftcollege.Edu<br \/><\/div><fieldset id=\"field_28_12\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Alternate Media Format Requested<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_28_12'>\n\t\t\t<div class='gchoice gchoice_28_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Electronic Text'  id='choice_28_12_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_12_0' id='label_28_12_0' class='gform-field-label gform-field-label--type-inline'>Electronic Text<span class=\"radio-button\" role=\"none\">\n\t\t\t\t\t<span class=\"radio-button__center\"><\/span>\n\t\t\t\t<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Audio Book'  id='choice_28_12_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_12_1' id='label_28_12_1' class='gform-field-label gform-field-label--type-inline'>Audio Book<span class=\"radio-button\" role=\"none\">\n\t\t\t\t\t<span class=\"radio-button__center\"><\/span>\n\t\t\t\t<\/span><\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_28_12_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='gf_other_choice'  id='choice_28_12_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_28_12_2' id='label_28_12_2' class='gform-field-label gform-field-label--type-inline'>Other<span class=\"radio-button\" role=\"none\">\n\t\t\t\t\t<span class=\"radio-button__center\"><\/span>\n\t\t\t\t<\/span><\/label><br \/><input id='input_28_12_other' class='gchoice_other_control' name='input_12_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_28_11\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Check all that apply.<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_28_11'><div class='gchoice gchoice_28_11_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.1' type='checkbox'  value='Doc'  id='choice_28_11_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_11_1' id='label_28_11_1' class='gform-field-label gform-field-label--type-inline'>Doc<span class=\"checkbox\" role=\"none\">\n\t\t\t<!--<svg class=\"brei-icon brei-icon-check\" focusable=\"false\">\n\t\t\t\t<use xlink:href=\"#brei-icon-check\"><\/use>\n\t\t\t<\/svg>-->\n\t\t<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_11_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.2' type='checkbox'  value='Learning Ally'  id='choice_28_11_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_11_2' id='label_28_11_2' class='gform-field-label gform-field-label--type-inline'>Learning Ally<span class=\"checkbox\" role=\"none\">\n\t\t\t<!--<svg class=\"brei-icon brei-icon-check\" focusable=\"false\">\n\t\t\t\t<use xlink:href=\"#brei-icon-check\"><\/use>\n\t\t\t<\/svg>-->\n\t\t<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_11_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.3' type='checkbox'  value='Large Print'  id='choice_28_11_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_11_3' id='label_28_11_3' class='gform-field-label gform-field-label--type-inline'>Large Print<span class=\"checkbox\" role=\"none\">\n\t\t\t<!--<svg class=\"brei-icon brei-icon-check\" focusable=\"false\">\n\t\t\t\t<use xlink:href=\"#brei-icon-check\"><\/use>\n\t\t\t<\/svg>-->\n\t\t<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_11_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.4' type='checkbox'  value='Kurzweil'  id='choice_28_11_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_11_4' id='label_28_11_4' class='gform-field-label gform-field-label--type-inline'>Kurzweil<span class=\"checkbox\" role=\"none\">\n\t\t\t<!--<svg class=\"brei-icon brei-icon-check\" focusable=\"false\">\n\t\t\t\t<use xlink:href=\"#brei-icon-check\"><\/use>\n\t\t\t<\/svg>-->\n\t\t<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_11_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.5' type='checkbox'  value='Bookshare'  id='choice_28_11_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_11_5' id='label_28_11_5' class='gform-field-label gform-field-label--type-inline'>Bookshare<span class=\"checkbox\" role=\"none\">\n\t\t\t<!--<svg class=\"brei-icon brei-icon-check\" focusable=\"false\">\n\t\t\t\t<use xlink:href=\"#brei-icon-check\"><\/use>\n\t\t\t<\/svg>-->\n\t\t<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_11_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.6' type='checkbox'  value='Tactile Graphics'  id='choice_28_11_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_11_6' id='label_28_11_6' class='gform-field-label gform-field-label--type-inline'>Tactile Graphics<span class=\"checkbox\" role=\"none\">\n\t\t\t<!--<svg class=\"brei-icon brei-icon-check\" focusable=\"false\">\n\t\t\t\t<use xlink:href=\"#brei-icon-check\"><\/use>\n\t\t\t<\/svg>-->\n\t\t<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_11_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.7' type='checkbox'  value='PDF'  id='choice_28_11_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_11_7' id='label_28_11_7' class='gform-field-label gform-field-label--type-inline'>PDF<span class=\"checkbox\" role=\"none\">\n\t\t\t<!--<svg class=\"brei-icon brei-icon-check\" focusable=\"false\">\n\t\t\t\t<use xlink:href=\"#brei-icon-check\"><\/use>\n\t\t\t<\/svg>-->\n\t\t<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_28_11_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.8' type='checkbox'  value='Braille'  id='choice_28_11_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_28_11_8' id='label_28_11_8' class='gform-field-label gform-field-label--type-inline'>Braille<span class=\"checkbox\" role=\"none\">\n\t\t\t<!--<svg class=\"brei-icon brei-icon-check\" focusable=\"false\">\n\t\t\t\t<use xlink:href=\"#brei-icon-check\"><\/use>\n\t\t\t<\/svg>-->\n\t\t<\/span><\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_28_13\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_13'>Comment<\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_28_13' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_28_14\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Step 3<\/h3><div class='gsection_description' id='gfield_description_28_14'>For each textbook you are requesting, please list textbook title edition, author, ISBN, and class\/Instructor.<\/div><\/div><div id=\"field_28_15\" class=\"gfield gfield--type-form gform-theme__no-reset--children field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_15'>TextBook Request<\/label><div class=\"gpnf-nested-entries-container ginput_container\">\n\n\t<table class=\"gpnf-nested-entries\">\n\n\t\t<thead>\n\t\t<tr>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-3\">\n\t\t\t\t\tTitle\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-4\">\n\t\t\t\t\tEdition\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-5\">\n\t\t\t\t\tAuthor\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-6\">\n\t\t\t\t\tISBN - 10 or 13\t\t\t\t<\/th>\n\t\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-field-7\">\n\t\t\t\t\tClass \/ Instructor\t\t\t\t<\/th>\n\t\t\t\t\t\t<th scope=\"col\" class=\"gpnf-row-actions\"><span class=\"screen-reader-text\">Actions<\/span><\/th>\n\t\t<\/tr>\n\t\t<\/thead>\n\n\t\t<tbody data-bind=\"visible: entries().length, foreach: entries\">\n\t\t<tr data-bind=\"attr: { 'data-entryid': id }\">\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f3.label, attr: { 'data-value': f3.label }\"\n\t\t\t\t\tdata-heading=\"Title\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f4.label, attr: { 'data-value': f4.label }\"\n\t\t\t\t\tdata-heading=\"Edition\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f5.label, attr: { 'data-value': f5.label }\"\n\t\t\t\t\tdata-heading=\"Author\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f6.label, attr: { 'data-value': f6.label }\"\n\t\t\t\t\tdata-heading=\"ISBN - 10 or 13\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t\t<td class=\"gpnf-field\"\n\t\t\t\t\tdata-bind=\"html: f7.label, attr: { 'data-value': f7.label }\"\n\t\t\t\t\tdata-heading=\"Class \/ Instructor\"\n\t\t\t\t>&nbsp;<\/td>\n\t\t\t\t\t\t<td class=\"gpnf-row-actions\" style=\"display: none;\" data-bind=\"visible: true\">\n\t\t\t\t<ul>\n\t\t\t\t\t<li class=\"edit\"><button type=\"button\" class=\"edit-button gform-theme-button--secondary\" data-bind=\"click: $parent.editEntry, attr: { 'aria-label': 'Edit Textbook {0} where Title is {1}.'.gformFormat( $index() + 1, f3.label ) }\">Edit<\/button><\/li>\n\t\t\t\t\t\t\t\t\t\t<li class=\"delete\"><button type=\"button\" class=\"delete-button gform-theme-button--simple gform-theme-button--size-md\" data-bind=\"click: $parent.deleteEntry, attr: { 'aria-label': 'Delete Textbook {0} where Title is {1}.'.gformFormat( $index() + 1, f3.label ) }\">Delete<\/button><\/li>\n\t\t\t\t<\/ul>\n\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t\t<tbody data-bind=\"visible: entries().length <= 0\">\n\t\t<tr class=\"gpnf-no-entries\" data-bind=\"visible: entries().length <= 0\" style=\"display: none;\">\n\t\t\t<td colspan=\"6\">\n\t\t\t\tThere are no <span>Textbooks.<\/span>\t\t\t<\/td>\n\t\t<\/tr>\n\t\t<\/tbody>\n\n\t<\/table>\n\n\t<button type=\"button\" class=\"gpnf-add-entry\"\n\t\t        data-formid=\"28\"\n\t\t        data-nestedformid=\"29\"\n\t\t\t\tdata-bind=\"attr: { disabled: isMaxed }, css: { 'gf-default-disabled': isMaxed }\"\n\t\t\t\t>\n\t\t\t\tAdd Textbook\n\t\t\t<\/button>\t\n\t\t\t<p class=\"gpnf-add-entry-max\" data-bind=\"visible: isMaxed\" style=\"display: none;\">\n\t\t\t\tMaximum number of textbooks reached.\n\t\t\t<\/p>\n<\/div>\n<input type=\"hidden\"\n                name=\"input_15\"\n                id=\"input_28_15\"\n                data-bind=\"value: entryIds\"\n                value=\"\" \/><div class='gfield_description' id='gfield_description_28_15'>If you do not have all the information needed to fill out the book request form, please, <a href=\"http:\/\/bookstore.taftcollege.edu\/SelectTermDept\">click this link to the bookstore<\/a> to help you fulfill your request. <\/div><\/div><div id=\"field_28_16\" class=\"gfield gfield--type-fileupload field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_28_16'>Receipt Upload<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_28_16' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_28_16&quot;,&quot;container&quot;:&quot;gform_multifile_upload_28_16&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_28_16&quot;,&quot;filelist&quot;:&quot;gform_preview_28_16&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/ct-prod-wp.taftcollege.edu\\\/forms\\\/?gf_page=46c9246ddf994a9&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/ct-prod-wp.taftcollege.edu\\\/forms\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/ct-prod-wp.taftcollege.edu\\\/forms\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;jpg,png,pdf,doc,docx&quot;}],&quot;max_file_size&quot;:&quot;83886080b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:28,&quot;field_id&quot;:16,&quot;_gform_file_upload_nonce_28_16&quot;:&quot;2031754aec&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;20&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_28_16&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_28_16' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_28_16' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_28_16 gfield_description_28_16\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_28_16'>Accepted file types: jpg, png, pdf, doc, docx, Max. file size: 80 MB, Max. files: 20.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_28_16'><\/ul> <div id='gform_preview_28_16' class='ginput_preview_list'><\/div><\/div><div class='gfield_description' id='gfield_description_28_16'>Upload an image or document of receipt.<\/div><\/div><fieldset id=\"field_28_18\" class=\"gfield gfield--type-consent gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_consent'><input name='input_18.1' id='input_28_18_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_28_18\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_28_18_1' >I agree to the Alternative Media Student Contract.<\/label><input type='hidden' name='input_18.2' value='I agree to the Alternative Media Student Contract.' class='gform_hidden' \/><input type='hidden' name='input_18.3' value='5' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_28_18' tabindex='0'><h3>Taft College Disabled Student Programs and Services Department (DSP&S) Alternate Media Student Contract<\/h3> Please read the information and type your name and date:<br \/><br \/> <b>1<\/b>. Persons requesting alternate media of their textbook(s) must have verification of a disability. Students may schedule an appointment with our learning specialist to receive information about eligibility. Please call 661-763-7799 for more information.<br \/> <b>2<\/b>. Students must currently be registered at Taft College and must be enrolled in the course for which they are requesting alternate media.<br \/><b>3.<\/b> Students requesting materials in alternate formats must own a physical copy of the textbook or other course materials (if applicable) before alternate media is distributed.<br \/> <b>4.<\/b> Alternate media production may take up to 2 weeks. Orders will be completed in the order in which they are received. Turn-around times may vary according to the type of request.<br \/> <b>5.<\/b> Materials provided to DSP&S for the purpose of converting to alternate format may be disassembled and returned to the student in an altered condition.<br \/> <b>6.<\/b> Students will be provided with one alternate format copy of each material requested. The course material provided in alternate format is for the sole use of the DSPS student who made the request and was authorized to receive it. Students may not reproduce or distribute any alternate media provided by DSPS. Doing so is violation of copyright law. Students may retain the alternate media provided by DSPS for as long as they own a copy of the original material. Students who sell their original material must return the alternate media to DSPS or agree to delete the files from their computer.<br \/> <b>7.<\/b> Infringement of copyright law or any abuse of the alternate media student contract is subject to suspension of the DSPS accommodation. <\/div><\/fieldset><div id=\"field_28_19\" class=\"gfield gfield--type-signature field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_28_19'>Signature<\/label><input type='hidden' value='' name='input_19' id='input_28_19_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_28_19_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><canvas id='input_28_19' width='300' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/ct-prod-wp.taftcollege.edu\/forms\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_28_19_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id = 'input_28_19_resetbutton' 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