Accessible Media – Request ServicesHome / Accessible Media – Request Services Request Process and Procedures Caption Files Finding Accessible Media through Mason Libraries Creating Accessible Multimedia Content Do It Yourself – Accessible Media Frequently Asked Questions Contact the Accessible Media Coordinator Robert Starr Accessible Media Coordinator Assistive Technology Initiative MS: 6A11 Voice: 703-993-5644 Fax: 703-993-4743 email@example.com ATI Services Required Field* Name* Email* Phone NumberMason Affiliation*Faculty/StaffStudentVisitorReason for Request*Please SelectCaptioning/Audio DescriptionDocument Accessibility ReviewODS/CDE Technology ReferralLearning Services ReferralWebsite/Software Tools (web and non-web) Accessibility ReviewReport an Access Barrier (physical and/or technology)Reason for Request*Please SelectAccessible TextTechnology TrainingReport an Access Barrier (physical and/or technology)Reason for Request*Please SelectReport an Access Barrier (physical and/or technology)Registration Status*Please SelectOffice of Disability ServicesMason Life ProgramOther Accommodation RequestReferral Date* Month Day Year For bulk requests (e.g., 2 or more files), please use the Accessible Media Bulk Request Form (Excel) and attach to an email to firstname.lastname@example.org. For Kaltura users: If your videos are hosted on Kaltura, please tag each video being requested with “captions.” This ensures that the ATI staff can locate the correct videos corresponding to the request. Please submit all accessible media requests at least 7 days prior to the date needed.Any Mason faculty and/or staff member can submit document requests. Priority is given to those faculty members who have a student with a documented print disability and is registered with Disability Services. All other requests will be determined on a case-by-case basis. SUBMISSION REQUIREMENTS: Before submitting your documents, the faculty/staff member must add the following: For Word documents Alternative text for all meaningful images, charts, graphs, and objects*. For PPT presentations Make sure you use the built-in slide layouts* Alternative text for all meaningful images, charts, graphs, and objects* For multiple images on one slide, group image and then add alt text for the grouped image. For PDF documents Send as is! Visit Accessibility Resource Videos and Creating Accessible Microsoft Office Documents on the ATI Website for additional guidance. Turnaround Time: Please allow approximately 2 weeks to process your requests. Depending on the time of year, this timeline may be much shorter (e.g., several weeks after start of Fall/Spring semesters, Summer sessions).Are you implementing a new website or web-based software application? Are you a faculty member using new technology in the classroom or your online course and need to know if it is going to be accessible to everyone? We can help! Complete this form so that ATI staff can test it with commonly used assistive technology applications (i.e., screen reader software, screen magnification, voice recognition, etc.). Captioning Audio Description Date Needed By (mm/dd/yyyy)* Month Day Year Instructor Name* Course Name and Number (Please enter format i.e. SOCI 100-001 if available)* College/School/Department* Instructional Designer you are working with (if any)?*Please selectAla ShowersCatesby PorfirenkoJade GearyKatrina JohnsonLarisa OlesovaLaura ToddMariya KhanMonisha TripathyI am not working with an IDType of Request*Disability AccommodationCompliance (Distance Education Course)Compliance (Face 2 Face Course)Compliance (Mason Website)SemesterFallSpringSummerMaterial Title* Are you the copyright holder of the material?YesNoIf No, who is the copyright holder? (Please provide as much contact information as possible.) Length of media to be captioned (total minutes - if seconds round up)* Format of media to be captioned*DVDAudio FileAudio-Video File (MP4-AVI-WMV-MOV-FLV)Web URLDelivery of Media to ATI*Media Located at Library (hardcopy)Media Located at Library (database or streaming)Drop off DVD/CD/Flashdrive to ATIEmail media file(s) to ATIDropBox media file(s) to ATIWeb URL in RequestVideos hosted on KalturaI confirm this material is legal and will be used for educational purposes*YesNoAdditional Information (i.e., links)Responsibility Acknowledgement* I acknowledge that video(s) will be used for at least one year. Video(s) transcripts are the property of George Mason University and thus will only be used on GMU websites and/or in classrooms. ATI will provide the following: Copy of video transcript (text file only) completed to at least 98% accuracy. ATI will not edit transcripts unless egregious errors are identified (i.e., accuracy or timing of captions) Confirmation emails sent upon receipt of your submission for processing, at the completion of your request, and as-needed throughout the process Requester Name* Semester*FallSpringSummerIs this an academic or non-academic request?*Please selectAcademicNon-academicPLEASE NOTE: Academic - Resource(s) intended to be used in the classroom. Faculty member (if different than requester) Instructional Designer you are working with (if any)?*Please selectAla ShowersCatesby PorfirenkoJade GearyKatrina JohnsonLarisa OlesovaLaura ToddMariya KhanMonisha TripathyI am not working with an IDCourse Name* Type of Course*Distance Education (Online)Face to FaceHybridIs this a publisher resource (e.g., Pearson MyLab, McGraw Hill Connect, MapleTA, etc.)?*Please selectYesNoList Publisher Resource(s) below (max - 5):* PLEASE NOTE: Click the '+' sign to add additional resources.Additional Information (Re: Publisher Resource)*Please provide as much information as possible about the publisher resource(s) that you plan to use (i.e., name of resource(s), type, intended use in classroom, how it can be accessed, etc.).Is this an application (e.g., Piazza, VoiceThread, Wikis, Blogs, etc.) to be used outside of the LMS?*Please selectYesNoList Application(s) below (max - 5):* PLEASE NOTE: Click the '+' sign to add additional applications. Additional Information (Re: External Applications)*Please provide as much information as possible about the external application(s) that you plan to use (i.e., name of resource(s), type, intended use in classroom, how it can be accessed, etc.).Is this a website (e.g., web-based article, blog, etc.)?*Please selectYesNoList Website URLs below (max - 20 sites):* PLEASE NOTE: Click the '+' sign to add additional URLs. Unit/Department* Is this a software application or website?*Please selectSoftware ApplicationWebsiteName of Software Application* Additional Information (Re: Software Application)*Please provide as much information as possible about the application(s) that you plan to implement (i.e., name of resource(s), type, intended use, how it can be accessed, etc.).List Website URLs below (max - 5 sites):* PLEASE NOTE: Click the '+' sign to add additional URLs. Additional Information*Please provide any additional information about the website(s) to be tested (i.e., content author, web developer, etc.).Campus or Location of Barrier*Please SelectFairfaxArlingtonScience and Technology (Prince William County)Arlington Campus LibraryLaw LibraryFenwick LibraryGateway (JC) LibraryMercer LibraryOnlineOtherIf Other, Please describe Describe the access barrier and whether it is physical or technology based: (i.e. website accessibility, classroom technology, document accessibility, non-captioned videos, library access, etc.) Please be as detailed as possible and include any website links if applicable.*Have you made any other contacts to try to rectify this problem?*YesNoIf yes, please provide the following information:Name of person contacted: Position: Email: Phone Number: Additional InformationWe appreciate you bringing this concern to our attention. Please select the Submit button and ATI will contact you shortly.Referral Name (Name of Student or Employee being Referred)* First Last Referral Mason Affiliation*StudentFacultyStaffG Number (include 'G' before number)* Referral GMU Email Address* Referral Phone (Cell)Referral Phone (Home/Work)Nature of Impairment (Please also discuss functional limitations, if any):*Current Technology and Devices (Please select the technology and/or devices that the student/employee is currently using. Add additional descriptions in the Comments field below).* None Communication Aids (Proloquo2Go, Dynavox, Other devices) Organization Software (Inspiration Software, Evernote, Other) Amplification System Mobility Aids (Wheelchair, Walker, Cane) Text to Speech Software (Read & Write, Kurzweil, etc.) Computer- Mac Computer- PC Mobile Device (iPad, iPhone, Android, Kindle, Other) MS Office 2010/2013 Voice Recognition (Dragon Naturally Speaking, Other) Screen Reading Software (JAWS, NVDA, Other) Magnification Software (Zoomtext, Windows Magnifier, Other) Adaptive Input (Trackball Mouse, Ergonomic Keyboard, Other) Recording Device (Smartpen, Digital Recorder) Other Comments for Other Current Technology:Accommodations student/employee is approved for:* Accessible Electronic Text (Books in Word, PDF or other accessible formats) Extended time for in class quizzes, tests and exams Use of a computer for writing Spelling Use of alternative testing accommodation for tests/quizzes using Scantron form Note-taking services Computer access during class Copies of lecture notes/outlines/PPT presentations Text to Speech Software (Read & Write, Kurzweil, etc.) -- used primarily by students with print impairments related to learning/cognitive challenges Screen Reading Software (i.e., JAWS, WindowEyes, etc.) -- used primarily by students with print impairments related to vision loss Tools/Supports to aid with eye fatigue, strain, etc. (e.g., built-in iOS, Mac, PC features. etc.) Audio recorded lectures (i.e., handheld digital recorder, Livescribe Smart Pen) Speech Recognition Software (i.e., Dragon Naturally Speaking) Use of a calculator for quantitatively based exams Use of personal FM system/remote captioning Other accommodations Comments for Other AccommodationsWhere will the student/employee be using this technology? (Classroom, workplace, outside the classroom, during testing, etc...please specify)* Goals- What specifically would you like to gain from this evaluation?Student Name* Unit making accommodation request* Date Submitted (Please Note: Minimum 2 Week Turnaround Time)* Month Day Year Semester*FallSpringSummerYear* Department/Course #* Type of Material*BookArticleE-ReserveOtherIf Other, please describe: Type of Format Requested (check all that apply)* Braille DAISY HTML MS Word Power Point PDF RTF Tactile Graphics TXT Material Title* Publisher* ISBN* CommentsCopyright Agreement* In accordance with the United States Copyright Law: Chapter 1 of Title 17, United States Code, Section 121: I agree to provide proof of purchase (receipt) for each textbook/material requested to be converted into electronic or alternate format. Additional Notes: I understand the ATI is not able to cut and rebind rented books. Completed requests are scanned on a first come, first served basis. A confirmation email will be sent as orders are completed. The accessible format is for your educational use only and may not be reproduced. After selecting the submit button, please email any documents that you need converted as mentioned in this request to: email@example.com Type of request?*Disability AccommodationComplianceDocument Accessibility Pilot (SOUPR/OCDI)Please indicate the type of request you have: 1. I have a student with a print disability that has an immediate need (i.e., Disability Accommodation) 2. I simply need assistance developing accessible course content (i.e., Compliance) 3. I am part of SOUPR or OCDI (operated through the Stearn's Center) Number of Documents with this Request* Document Type(s)- Select all that apply* Word PDF Power Point Tactile Graphic Other Instructional Designer you are working with (if any)?*Please selectAla ShowersCatesby PorfirenkoJade GearyKatrina JohnsonLarisa OlesovaLaura ToddMariya KhanMonisha TripathyI am not working with an IDIf Other, please describe: Date Needed By:* Semester when documents will be used:*SummerFallSpringTo assist us with prioritizing document requests, please indicate the semester that you will use the documents.Course Prefix - Course # (If Applicable- Example: EDAT - 521)* If this request is not related to a particular course, please indicate the unit's name or acronym (e.g., Disability Services or DS). Additional InformationFile Upload (max - 20 files, 8MB per file)* Drop files here or Select files Accepted file types: doc, docx, ppt, pptx, pdf, Max. file size: 8 MB, Max. files: 20. Learning Services Staff Name* Learning Services Staff Email* Name and email of staff member making referral.Referral Name (Name of Student Being Referred)* Referral Email* Referral Phone Number Reason for Referral (Check all that apply)* Training on Read & Write by Texthelp Training on Scanning Stations to self-scan documents/textbooks Training on Note-taking/Organization mobile apps Other Technologies If Other, Please Describe: What technology does the student currently use? (Check all that apply) PC Mac iOS Device (iPhone/iPad) Android Device (Tablet, Smartphone) Other What technology do you currently use? (Check all that apply)* PC Mac iOS Device (iPhone/iPad) Android Device (Tablet/Smartphone) Other For Other, Please Describe: Comments or QuestionsCollege or School* Course Name and Number (Please enter format i.e. SOCI 100-001 if available)* Semester/Year course will be taught* Responsibility Acknowledgement* I acknowledge that I will give ATI access to my course after receiving confirmation from an ATI staff member that my request has been received. Comments or QuestionsCommentsThis field is for validation purposes and should be left unchanged.