Semester Accommodation Request Form

Which campus or campuses are you attending?
How would you like to receive your letter of accommodation?
Read each line carefully and provide your initials for each line.
Line 1: I understand that it is my responsibility to notify the Disability Coordinator of any changes to my class schedule immediately.
Please sign your initials.
Line 2: I understand that if I do not plan to attend a class that has a scheduled Interpreter or Captionist, I will notify the ODS Coordinator and Service Provider at least 24 hours in advance prior to the beginning of class via text, email, or telephone.
Please sign your initials.
Line 3: I understand the Interpreters, Captionists, or Note-Takers that are assigned to my class will leave 15 minutes after the instructor starts class if I am not in attendance, and I will be marked as a "No Show" for that class.
Please sign your initials.
Line 4: I understand that after three documented consecutive "No Shows" for the semester, my services will be temporarily suspended until I meet with my Disability Service Coordinator.
Please sign your initials.