Accommodation Letter Request Form

Students registered with the Disability Services for Students office notify their professors of their disability related accommodation needs with Request for Accommodations (RFA) Letters signed by a DSS Coordinator. Students with disabilities are advised to request and present these letters during the first week of each semester so that accommodations can be provided in a timely manner.

Please provide the following information:

Today's date: *

Student name: *

CCRI ID: *

Campus: *

Semester:

Phone number: *

Email *

List the classes for which you are requesting accommodation letters.

Please use the following format: class abbreviations, number, and section.

Examples: MATH 0500 001, ENGL 0250 005

Class 1

Class 2

Class 3

Class 4

Class 5

Exam Accommodations

I require the same accommodations I did during my last semester.

I require different accommodations than during my last semester. I will contact my DSS Coordinator to discuss these changes.