(1) Certifies that the institution of higher education has purchased the printed instructional material for use by a student with a disability or that a student with a disability attending or registered to attend that school has purchased the printed instructional material;
(2) Certifies that the student has a disability that prevents him or her from using standard instructional materials;
(3) Certifies that the printed instructional material is for use by the student in connection with a course in which he or she is registered or enrolled; and
(4) Is signed by the coordinator of services for students with disabilities at the institution of higher education and by an official responsible for monitoring compliance with the Americans with Disabilities Act of 1990, 42 U.S.C. § 12101 et seq. At the request of the institution of higher education, the Division of State Services for the Blind of the Department of Human Services or the Department of Career Education may prepare and sign the certification.