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The Accessibility Office 275 Swamp Road Newton, PA 18940 BUCKS COUNTY COMMUNITY COLLEGE 215-968-8463 (Fax) 215-968-8033 Date Received by DS Office: Request for Academic Adjustments CHECK ONE Who should
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How to fill out academic adjustment request form
Who needs academic adjustment request form?
01
Students who require accommodations for academic purposes.
02
Students who have a documented disability or medical condition that impacts their ability to participate fully in their academic program.
03
Students who need modifications to their class schedule or assignments due to extenuating circumstances.
How to fill out academic adjustment request form:
01
Obtain the form: Start by contacting your school's disability services office or academic support center to request the academic adjustment request form. They will guide you on where to find the form or provide it to you directly.
02
Read the instructions: Carefully read through the instructions provided with the form. They will outline the process, eligibility criteria, and any supporting documents required.
03
Provide personal information: Fill out the required personal information section of the form, including your name, student identification number, contact details, and other relevant identification information.
04
Specify your disability or medical condition: Clearly describe your disability or medical condition that necessitates the need for academic adjustments. Be concise yet detailed in explaining how it impacts your ability to participate fully in your academic program.
05
Document supporting evidence: Attach any supporting documentation that validates your disability or medical condition. This may include medical records, diagnostic reports, or assessments conducted by healthcare professionals.
06
Specify requested adjustments: List the specific academic adjustments you are seeking. These adjustments may include extended time for exams, alternative format materials, assistive technology, note-taking services, or modifications to class assignments.
07
Provide additional information: Use this section to include any additional information that you believe is relevant to your request. This can include your previous experiences with academic accommodations, specific challenges you have faced, or any additional needs you may have.
08
Seek professional verification: Consult with your healthcare provider, educational psychologist, or other relevant professionals to complete any sections that require professional verification. This may include confirming the disability or medical condition, recommending specific accommodations, or providing further insight into your situation.
09
Submit the form: Once you have completed the form and gathered all necessary supporting documentation, submit it to the designated office or individual indicated on the form. Ensure that you meet any stated deadlines to avoid delays in the processing of your request.
10
Follow up: After submitting the form, follow up with the disability services office or academic support center to ensure that your request is being processed. They may request additional information or schedule a meeting to discuss your needs further. Stay engaged with the process to ensure a successful outcome.
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What is academic adjustment request form?
The academic adjustment request form is a document used to request accommodations or changes to a student's academic program.
Who is required to file academic adjustment request form?
Students who require accommodations or changes to their academic program are required to file the academic adjustment request form.
How to fill out academic adjustment request form?
To fill out the academic adjustment request form, students must provide detailed information about the accommodations or changes they are requesting.
What is the purpose of academic adjustment request form?
The purpose of the academic adjustment request form is to ensure that students receive the necessary accommodations or changes to succeed in their academic program.
What information must be reported on academic adjustment request form?
Students must report specific details about the accommodations or changes they are requesting, along with any supporting documentation.
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