Accommodation Letter Request Form
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1D i s a b i l i t y S e r v i c e s O f f i c e
Accommodation Letter Request Form
Students registered with the DSO are to notify their professors of their
disability-related accommodation needs when they present the Accommodations
Letters signed by their DSO contact person. Students with disabilities are
advised to request and present these letters during the first week of each new
semester so accommodations can be provided in a timely manner. Students
should make arrangements to speak with their professors privately either during
faculty office hours or directly before or after class in order to discuss their
accommodations. Students should contact DSO immediately if they have any
concerns or difficulties with the provision of accommodations.
________________________________________________________________
Student Name: __________________________________________________
Date letters requested: ____________
Please only list class abbreviations, number, and section letter as well as
instructor’s name (ex. MTH 1111A, ENG 1040N, etc).
1. Class: __________________
Professor: _________________________
2. Class: __________________
Professor: _________________________
3. Class: __________________
Professor: _________________________
4. Class: __________________
Professor: _________________________
5. Class: __________________
Professor: _________________________
6. Class: __________________
Professor: _________________________
The following section should be signed when you pick up your letters in order
to signify receipt of letters:
Student signature: ______________________________ Date __________
Letters prepared by: ______________________________ Date __________
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