Office of Disability Services • Morgan University Center 114 • P.O. Box 4578 • Clarksville, TN 37044 • (931) 221-6230(v) • (931) 221-6278(tty) • (931) 221-7102(f) • firstname.lastname@example.org
ACCOMMODATION LETTER REQUEST FORM
Year of Term
Student’s Name (print) Date Attending
Location MAIN CAMPUS FORT CAMPBELL
Semester Fall Spring Maymester Fall I Fall II Spring I
Student’s Signature (circle one) Summer I Summer II Full Summer Spring II Summer III Winter-mester
I hereby request the Office of Disability Services to prepare accommodations letter(s) for distribution to the following professors:
PROFESSOR’S NAME COURSE, CLASS NUMBER and SECTION Auxiliary Aide Service Requested
(Title, First, Last) (Example – American History I / HIST 2010-01) Class Day(s) & Times
Note Taker Note Taker Other
Needed Identification (Example- Interpreter)
1) Yes No Yes No
2) Yes No Yes No
3) Yes No Yes No
4) Yes No Yes No
5) Yes No Yes No
Faculty/Student Conference Forms
(All faculty/student conference forms may be picked-up after 12 noon on the day they are due) ODS Staff Signature
WHITE – File Copy YELLOW – Auxiliary Aide PINK – Student Copy
Revised 4/27/12 – THIS FORM SUBMITTED VIA EMAIL TO ODS@APSU.EDU WILL SERVE AS THE STUDENT’S ELECTRONIC SIGNATURE.
Responsibilities of Students Receiving Assistance Through the Office of Disability Services
Identify themselves in a timely manner as an individual with a disability when seeking an accommodation.
Provide documentation from an appropriate professional source that verifies the nature of the disability, functional limitations, and the need
for specific accommodations.
Contacting ODS at the beginning of each semester so that appropriate accommodations can be requested in a timely manner. Students are
strongly encouraged to make this contact the last week of the semester prior to, or within the first two weeks of each semester. This includes
filling out the accommodation letter request, which indicates the student’s need (e.g., extended time to complete exams, note taker, sign
language interpreter, laboratory assistant, etc.).
Accommodations are not retroactive and begin after accommodation letters have been sent to professors.
Meet the timelines and procedural requirements established by the ODS. If the student fails to provide adequate notice of the need for space
and/or assistance, he/she is still entitled to the accommodation, but there is no guarantee that it can be provided in the fullest measure.
Your APSU e-mail address will be considered your official form of communication for all APSU correspondence.
Accommodation Letter Distribution Procedures
On campus Procedures:
1. The student completes the accommodation letter request form (ALRF) and returns it to the Office of Disability Services (ODS).
a. If this form is completed and returned to ODS during pre- registration for the upcoming semester, accommodations letters will be
prepared and sent via email to the professor(s) and student prior to the first day of class.
b. If this form is completed and returned to ODS after the first day of class, accommodations letters will be prepared and sent via email to the
professor(s) and student after 12 noon on the third business day. (Example- Monday, letters will be available after 12 noon on Thursday.)
c. It is the student’s responsibility to follow-up with the professor(s) to confirm receipt of the emailed accommodation letter(s).
2. The student will be responsible for picking up the Faculty/Student Conference forms from ODS.
NOTE: Please refer to the front of the ALRF for the pickup date for the conference forms.
3. The student will meet with his/her professor(s) in a location that protects the student’s confidentiality (i.e. in the faculty member’s office) to complete
the Faculty/Student Conference form and discuss how accommodations will be rendered.
4. At the conclusion of the meeting faculty members are asked to provide a copy of the completed conference form to the student and return a copy to
ODS by campus mail.
Online Course Procedures:
1. Online classes will follow the same process of requesting accommodation letters by submitting the ALRF to the Office of Disability Services.
2. If the class is online, the conference can be either through APSU email between the faculty member and student with ODS copied in the email or by
telephone followed by an APSU email detailing the conversation with ODS copied in the email.
1. Request a note-taker for each class on the ALRF as well as indicate your preference for maintaining anonymity or being identified to the note-taker.
2. ODS recruits note-takers via the class roster and APSU email. The process is as follows:
a. ODS recruits volunteers through APSU email.
b. The student conferences with the professor to discuss accommodations including note-taking. Note-taking may include: a volunteer from
within the class, recording device such as digital recorder or an iPad2, and/or lecture notes from the professor or Desire 2 Learn (D2L).
c. ODS reviews the note-taker applications and assigns the selected volunteer.
d. ODS will notify the student on the status of the note-taker within the first two weeks of each semester.
e. Note delivery is requested on Thursday and Friday or the class day before a test. ODS will notify students via APSU email.
f. Students are responsible for picking up notes from the ODS office.
1. The student and instructor coordinate the exam schedule with ODS.
2. Due to the high volume of tests given in the ODS office, the student is encouraged to make an appointment ONE WEEK prior to the date of test.
3. Extended Time: The standard for extended time at APSU is time and a half. Ex: MWF classes have 1.5 hours to complete the test.
4. Reader/Scribe: ODS will coordinate with the student and faculty to provide a reader.
5. Minimal Distraction Location: ODS will provide a location based upon space availability. After capacity has been reached in the lab, other facilities
within the building or on campus may be utilized.
6. Tardy arrival: the total amount of time may not be altered due to late arrival without permission from the faculty member authorizing the test. Ex:
student arrives at 10:30 a.m. for an exam scheduled to begin at 10:00 a.m. The student may have the remainder of the scheduled time only.
7. Absences: In the event of an absence, please contact our office as well as your professor. The exam will be returned to the professor if the student
does not contact our office.
REMINDER: The student is responsible for Austin Peay State University academic policy, procedures and student code of conduct which may be found by
visiting the website: www.apsu.edu/policy and www.apsu.edu/student-affairs/judicial1
APSU Policy No. 3:008 Non-Academic Grievance Procedure.
APSU Policy No. 3:033 Student Course Grade Appeal Policy
APSU Policy No. 3:035 Student Academic Misconduct
APSU Policy No. 5:057 Grievance Procedures for Persons with Complaints related to the Americans with Disabilities Act.