Audio Transcription Order Form for Classroom Materials

Use this form if you are requesting audio transcription of print material that will be used in a course, class, seminar, or training session. Use a separate form for each book or set of materials. If you have any questions, please call us at 651-539-1422, 1-800-652-9000 or TTY 1-888-665-3276 and ask for the library technician.

This form consists of 7 parts: (1) audio type; (2) book and class information; (3) student information; (4) school information; (5) shipment information; (6) transcription instructions; and (7) signature. Be sure to complete all sections.

Mail to Audio Services, Communication Center, State Services for the Blind, 2200 University Avenue West #240, Saint Paul MN 55114-1840:

It is essential to include the reading assignment schedule containing specific dates with this form. This will assist us in providing reading installments on time and allow us to serve you better.

Audio Type

Book and Class Information

OR

Student Information

Qualifying Print Impairment

Customer Agreement and Copyright Notice
.

Permanent address, if different than above

School Information

Purchase Order Number

Billing name and contact information, if different than above

Shipment Information

Mail Audio Transcriptions to

Return Original Print Copy to

Include Braille Labels?

Transcribing Instructions

Indices will not be transcribed. Pictures and maps will be identified and captions read; they will not be described. Provide specific transcribing instructions as indicated below. Note any other instructions in the "Special Instructions" area.

Pages to Transcribe

Page Numbers

Footnotes

Tables, Charts, Graphs, Diagrams, Figures

Transcribe Checked Items

on pages

Table of Contents

Other - Specify

Signature