Letters to Professors Accommodations Request Form
Step one: Complete the form to request accommodations once you are registered through VIP. If you request services you MUST pick up a letter and take it to your professor at the beginning of the semester. Students are strongly encouraged to make requests for accommodations at the end of the semester for the upcoming semester and submit this form as soon as possible.
Date Requested:
Email:
Blackboard username:
First Name:
Last Name:
Gender Select Male Female
Birth Date:
Phone:
Requesting Accommodations For Semester: Select Fall Spring Mini-Term Summer I Summer II
Current Address:
Requesting Accommodations For Year:
City:
Academic Classification Select Freshman Sophomore Junior Senior Graduate
State: Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
GPA
Zip:
Registered with Vocational Rehabilitation Services? Yes No
Step two: Fill out the following form with your class schedule. This is required to receive any accommodations from our office. If you request alternative format texts please fill in your text information on the Alternative Format Textbook Request form as well. Please consider the accommodations you are requesting carefully. If there are any changes to your schedule or you change your mind about the accommodations you have requested, please let us know as soon as possible.
Dept.
Course
Section
Credits
Times
Days
Place
Accommodations requested:
1
2
3
4
5
6
7
8
9
10
Step three: No alternative accommodations should be made without prior approval of the Disabilities Services. Step four: You will be notified by email when your letters are ready. Step five: We recommend that you make an appointment to meet with each of your instructors as early in the semester as possible to discuss your accommodations in private, and when the instructor is not rushed. You are responsible for taking the accommodation request letter to the appointment with each professor. Step six: During the meeting with each of his/her professors, the student should cover the following areas:
Their disability
The approved accommodations
How the accommodations will be implemented
Any alternatives that may be considered
Step seven: If the instructor does not agree to or fails to follow the accommodations outlined in the accommodation form, the student is expected to notify the Office of Student Disability Services. It is also the student's responsibility to ensure that the instructor and the Office of Student Disability Services are providing him/her with the appropriate accommodations.
By initialing in the box below you are stating that you understand our policies and procedures and agree to the terms.
Initials
A confirmation page will appear when you click submit. Please print that page.