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Instructional Materials Center

IMClibrary@blind.state.ia.us

524 4th St. Des Moines, IA 50309

515-281-1323

IMC Student Materials Order Form

Teachers of the visually impaired and school personnel can use the below order form to order accessible instructional materials in braille, large print, and electronic formats for students in grades Pre-K-12. 

Person Submitting Form

Ship To (Staff Member):

Full Address


Teacher of the Visually Impaired (TVI) Information

Student Information

Student Name

Does the Student have either of the following?

If yes, select paper size:

Order Type (Select all that Apply)

Textbooks

Media Type - Textbook

How will the student access the electronic braille?

File Type

Large Print set at 20 

Will book be written in or pages torn out?

Textbook 2

Media Type - Textbook

How will the student access the electronic braille?

File Type

Font size is set at 20 

Will book be written in or pages torn out?

Textbook 3

Media Type - Textbook

How will the student access the electronic braille?

Font size set at 20

File Type

Will book be written in or pages torn out?

Textbook 4

Media Type - Textbook

How will the student access electronic braille?

Font size set at 20

File Type

Will book be written in or pages torn out?

Textbook 5

Media Type - Textbook

How will the student access electronic braille?

Font size set at 20

File Type

Will book be written in or pages torn out?

Textbook 6

Media Type - Textbook

How will the student access electronic braille?

Font size set at 20

File Type

Will book be written in or pages torn out?

Textbook 7

Media Type - Textbook

How will the student access electronic braille?

Font size set at 20

File Type

Will book be written in or pages torn out?

Textbook 8

Media Type - Textbook

How will the student access electronic braille?

Font size set at 20

File Type

Will book be written in or pages torn out?

Textbook 9

Media Type - Textbook

How will the student access electronic braille?

Font size set at 20

File Type

Will book be written in or pages torn out?

Textbook 10

Media Type - Textbook

How will the student access electronic braille?

Font size set at 20

Will book be written in or pages torn out?

Worksheets or Electronic Documents

Media Type - Worksheets/Electronic Document

How will the student access the electronic braille?

File Type

Font size is set to 20 

Will book be written in or pages torn out?

Upload File(s)

Click Here to Upload

Worksheets or Electronic Documents 2

Media Type - Worksheets/Electronic Documents

How will the student access the electronic braille?

File Type

Font size is set at 20

Choose One

Will book be written in or pages torn out?

Upload File(s)

Click Here to Upload

Worksheet or Electronic Documents 3

Media Type - Worksheets/Electronic Documents

How will the student access the electronic braille?

File Type

Font size is set at 20 

Will the book be written in or pages torn out?

Upload File(s)

Click Here to Upload

Worksheet or Electronic Documents 4

Media Type - Worksheets/Electronic Documents

How will the student access the electronic braille?

File Type

Font size is set at 20 

Will the book be written in or pages torn out?

Upload File(s)

Click Here to Upload

Worksheet or Electronic Documents 5

Media Type - Worksheets/Electronic Documents

How will the student access the electronic braille?

File Type

Font size is set at 20 

Will the book be written in or pages torn out?

Upload File(s)

Click Here to Upload

Little Readers (Leveled Readers for K-5)

Media Type - Little Readers

How will the student access the electronic braille?

File Type

Font size is set at 20 

Will the pages be written in or torn out?

Upload File(s)

Click Here to Upload

Quick Braille (Materials needed in 2 weeks or less)

Media Type - Quick Braille

How will the student access the electronic braille?

Font size is set at 20 

Will book written in or pages torn out?

Upload File(s)

Click Here to Upload

Quick Braille 2 (Materials needed in 2 weeks or less)

Media Type - Quick Braille

How will the student access the electronic braille?

Font size is set at 20 

Will book written in or pages torn out?

Upload File(s)

Click Here to Upload

Quick Braille 3 (Materials needed in 2 weeks or less)

Media Type - Quick Braille

How will the student access the electronic braille?

Font size is set at 20 

Will book written in or pages torn out?

Upload File(s)

Click Here to Upload

Assessments

Select One

Media Type - Assessments

FAST Reading Assessments

FAST Math Assessments & Progress Monitoring

How will the student access the electronic braille?

File Type

Font size is set at 20

Will book be written in or pages torn out?