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REQUEST FOR SECTION 504 ACCOMMODATIONS 20162017 Name of Student DOB / / School Name School ATS/DAN: Grade/Class Name of Requesting Parent/Guardian Relationship to Student: Date Submitted to the 504

How to fill out request for section 504

To fill out a request for Section 504, you can follow these steps:

1. Start by obtaining a copy of the request form for Section 504. This form is usually available on the website of the educational institution or organization responsible for implementing Section 504.
2. Carefully read the instructions provided on the form. This will give you a clear understanding of the information required and the documentation you need to provide.
3. Fill out your personal information accurately. This includes your name, contact details, and any other requested identifying information.
4. Provide a detailed description of the disability or impairment for which you are seeking accommodation under Section 504. It is important to clearly explain how this disability substantially limits a major life activity such as learning, walking, or communicating.
5. Include any relevant medical or psychological documentation that supports your claim. This may include assessments, reports, or letters from healthcare professionals familiar with your condition.
6. If applicable, list the specific accommodations or modifications you are requesting. Be specific about how these accommodations will enable you to fully participate in the educational or programmatic activities.
7. Sign and date the form, acknowledging that the information provided is accurate to the best of your knowledge.

Who needs a request for Section 504?

A request for Section 504 can be made by individuals who believe they have a disability that substantially limits their ability to participate in a major life activity. This can include students, parents or guardians of students, and individuals accessing programs or services offered by organizations covered under Section 504.

It is important to note that Section 504 covers a wide range of settings, including educational institutions, workplaces, and public entities. Therefore, anyone who believes they may benefit from accommodations or modifications due to a disability should consider submitting a request for Section 504 when applicable.

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