Austin Peay State University Office of Disability Services

Austin Peay State University • 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) • [email protected] ACCOMMODATION REQUEST FORM

Semester: Date: Student’s Name (print): Student ID # Phone # APSU Email: Student’s Signature:

Select Location by putting an X after your campus: MAIN CAMPUS FORT CAMPBELL HIGHLAND CREST

Alternative Format Program (AFP) requests must be submitted per book in addition to the Accommodation Request Form. I hereby request the Office of Disability Services to prepare accommodations letter(s) for distribution to the following professors: PROFESSOR’S NAME CLASS NUMBER and SECTION Note Taker Note Taker Other (First, Last) (Example – HIST 2010-01) Needed Identification i.e. Interpreter, Table or Chair Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No

Faculty/Student Conference Forms may be picked up on:

______ODS Staff Signature

WHITE – File Copy YELLOW – Auxiliary Aide PINK – Student Copy

* THIS FORM SUBMITTED VIA EMAIL TO [email protected] WILL SERVE AS THE STUDENT’S ELECTRONIC SIGNATURE. Revised 03/10/2015 Disability Services 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 request form (ARF) 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, accommodation letters will be prepared and sent via email to the professor(s) and student prior to the first day of class. a. If this form is completed and returned to ODS after the first day of class, accommodation letters will be prepared and sent via email to the professor(s) and student within one week or 5 business days. (Ex: ARF is submitted on Tuesday; letters will be sent by the following Tuesday afternoon). b. 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 ARF 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 a copy of the completed conference form should be returned to Disability Services. Online Course Procedures: 1. Online classes will follow the same process of requesting accommodation letters by submitting the ARF to the Office of Disability Services. 2. If the class is online, the conference will be conducted through email between the faculty member, student and [email protected] .

Note Taking

1. Request a note-taker for each class on the ARF 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. 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.

Testing

1. The student must schedule the exam with ODS. 2. Due to the high volume of tests given in the ODS office, the student is required to make an appointment A MINIMUM OF ONE WEEK prior to the date of test. 3. Test must be scheduled online: http://www.apsu.edu/disability-online-forms/disability-services-testing-sign-form. 4. 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. 5. Reader/Scribe: ODS will coordinate with the student and faculty to provide a reader/scribe. 6. 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. 7. Tardy arrival: the total amount of time may not be altered due to late arrival. 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. 8. 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.