Request for Accommodations
Danville Area Community College

Request Form

Biographical Data











Accommodations Requested



What is the impact of your condition?

     The following questions will help you to describe your condition, its impacts and your needs. Review them with your transition team, counselor, parents, and others who can help you anticipate the accommodations and services you will need at college. You may want to write notes to help you present your requests and explain your needs.

     It is helpful to think about how your condition has impacted you in various situations in the past; then to consider how it is likely to impact the typical activities you can expect to encounter at college. You may want to pay particular attention to the following contexts:







































Please select an answer for each:

The Danville Area Community College is not obligated to honor disability accommodations from previous institutions.

Accommodation I have used this before This has been helpful to me in the past I am requesting this from DACC N/A
For class notes
Tape Recorder
Note Taker

To access auditory/oral information
Sign-language interpreter
Assistive listening device
Closed-captioned videos

To access visual information
Talking Calculator
Video-print enlarger
Braille

Computer Assistive Technology
Dragon Naturally Speaking
Other

For tests/exams
Extended time for test/exams
Testing in a quiet, non-distracting environment
Word processor for essay tests
Spell Checker
Calculator
Reader/scribe

Course
Substitute/waiver
Digital Textbook
Reduced load





Agreement

   Academic requirements that are essential to the program of instruction being pursued by the student or to any directly related licensing or certification requirement will not be modified, substituted, or waived.

   I understand and agree to supply appropriate documentation to academic accommodations in order to ascertain if I am eligible for disability services at Danville Area Community College. I further understand that not all students with disabilities will qualify for disability services.

   The Danville Area Community College is not obligated to honor disability accommodations from previous institutions.

   Academic requirements that are essential to the program of instruction being pursued by the student or to any directly related licensing or certification requirement will not be modified, substituted, or waived.

   I understand and agree to supply appropriate documentation to academic accommodations in order to ascertain if I am eligible for disability services at Danville Area Community College. I further understand that not all students with disabilities will qualify for disability services.

   I understand to receive, each semester, auxiliary aids and services I must complete a Semester Request for Academic Accommodations form prior to the start of each semester.

   The information contained in this form is true and accurate to the best of my knowledge.

 









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