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Continuation of Accommodations Request

Sunday, October 25, 2020

Hours and Office Locations

Main Campus:

Campus Center Building, Room 241

Monday–Friday 8 a.m. - 4:30 p.m.

Phone: (501) 812-2738

Little Rock-South:

Disability Services, Room 105C

Counseling Services, Room 105E - Services are available by appointment. To make an appointment, please call (501) 812-2738.

If you are attending classes at UA - Pulaski Tech and would like to continue your accommodations, please complete and submit this form at least five business days prior to the start of the semester. Submissions sent after the start of a semester may result in a delay for receiving accommodations.

THIS FORM SHOULD BE COMPLETED BY CURRENT UA-PTC STUDENTS WHO'VE PREVIOUSLY RECEIVED ACCOMMODATIONS

*Required

*Term:
*Attending:

Emergency Evacuation

*In an emergency, would you need assistance exiting a building?
If you selected yes, please check all that apply:

I understand:

1. At least 5 business days BEFORE each semester starts that this online form for Continuation of Accommodations must be completed and submitted to the office Disability Services. Submissions sent late, may result in a delay for receiving accommodations.

2. Accommodation letter will be e-mailed to my UA-PTC student e-mail address. It is MY responsibility to e-mail or hand deliver a copy of my Accommodation Letter to my instructor(s).

3. Accommodations will only be provided once I've discussed them with my instructor. I choose which of the approved accommodations are needed for each class. It is MY responsibility to discuss my choices with each of my instructors. I will inform Disability Services if I need assistance discussing my accommodations with my instructor(s).

4. It is MY responsibility to inform Disability Services immediately if there are problems regarding receipt of accommodations and/or if any adjustments to accommodations need to be made.

5. Academic Advising - If I have any questions regarding my overall degree plan, I can contact the Office of Disability Services to make an appointment or I can schedule an appointment with the Academic Advising Center.

I understand that typing my full name in this box constitutes a legal signature confirming that I acknowledge and agree to the understandings above and agree to contact the office of disability services if my needs change.