_____________________________ has registered with the office of Student Accommodations
and Resources (StAR) at Joliet Junior College. Documentation has been provided by the student
for a disability covered under the Americans with Disabilities Act and Section 504 of the
Rehabilitation Act. It is appropriate and reasonable that accommodations be made which often
include missing class due to the illness.
It is the instructor’s purview to establish attendance requirements for this course in light of the
established goals and objectives of the course. Regarding both the student’s illness and the
goals and objectives of the class, it is the goal of this agreement to establish the maximum
number of absences allowed in this course. It is understood that excused absences are
explicitly for days on which the student is hospitalized or otherwise confined due to illness, or
when it is necessary to meet with the physician or emergency room staff. In the case of
hospitalization, doctor’s visits and visits to the emergency room the student will provide a note
on letter head paper or prescription pad indicating dates of the absence due to illness (within 1
week of last date of absence). In the event of an extended illness, the student is expected to
have weekly contact with the instructor (by email or phone as agreed upon).
The instructor has determined that the maximum number of absences allowed for this class in
consideration of the disability is: ______. Late work will be turned in to the instructor according
to the instructions of the instructor as shown below:
Student____________________________________ ID# ___________________________
Student signature/date Instructor signature/date
Student-Instructor Agreement for ADA
Academic Department Chair signature/date Student Accommodations and Resources manager signature/date
/504 extended illness/absence 2011
StAR will prepare copies for all persons signing this agreement and will forward to them.