Accomodation Request Form

IMPORTANT MESSAGE - PLEASE READ BEFORE CONTINUING!

 

As you complete this form, please make sure you do the following two things so the form is properly submitted.

 

#1) When you enter your Student ID Number, do not use any dashes.  Enter only the 9 digits of your ID Number.  For example:

 

Student I.D. Number *

 

 

#2) At the Accommodation Needed check boxes (pictured below) within the form, you must check at least one of the boxes.

 

If you need an accommodation that is not listed as an option, please go ahead and check one of the boxes but use the Additional Comments area to tell us about the specific accommodation you require. 

 

Accommodation Needed (Professor 1) *

  a. Extended Time on Test 

  b. Tape Record Lectures

  c. Note-taking Assistance

  d. Sign Language Interpreting

  e. Captioning Services

 

 Additional Comments (Professor 1)

 

Please keep these two items in mind as you complete the form below.