Semester Accommodation Request Form

Which campus or campuses are you attending?
How would you like to receive your letter of accommodation?
If you are requesting a Communication Facilitator (CF) in the classroom, please make a selection below:
select as many as needed
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.