Request For Special Format Materials And School-Authority Approved Diploma Exam Accommodations Form Page 2

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Administration:
November
January
April
June
August
S
:
S
C
:
CHOOL
CHOOL
ODE
J
:
J
C
:
URISDICTION
URISDICTION
ODE
N
P
P
O
(
):
AME OF
ERSON
LACING
RDER
PLEASE TYPE
E
P
P
O
(
):
MAIL OF
ERSON
LACING
RDER
PLEASE TYPE
Coloured Paper
Size (regular or large
Sample attached if
Subject
Colour
Quantity
print)
applicable
The special format materials requested above have been approved by the superintendent
Date
Telephone Number
Principal’s Name
Deadlines for submitting form:
November administration: October 4, 2017
January administration: November 10, 2017
April administration: February 23, 2018
June administration: April 12, 2018
August administration: July 4, 2018
Email this form and/or direct all questions to:
Special.Cases @gov.ab.ca
using the subject line: DEP ACC
SFM - your school name and school code (e.g. DEP ACC SFM – Ben Hur High School, 9999)
Your School Authority contact must be copied on the email
Page 2 of 2
Alberta Education – Request for Special Format Material 2017–2018
August 2017

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