Fillable Disability Resource Center (Norco College)

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Disability Resource Center (Norco College)

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U.S.A. forms for Norco College

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Reader TERM:
Notetaker FALL
Scribe WINTER
Table SPRING
Chair SUMMER
SmartPen
Name:
Student ID:
Describe briefly the accommodation that you are requesting:
Time Class Meets
Day(s)
(MWF, TTH)
Building and
Room #
Accommodation
Request
Please read before signing:
Student Signature: Date:
Department use:
Staff member assisting student
Date:
Classroom Request for Accommodations
Accommodation verified in SAM and Ellusion contact completed.
I understand that it is my responsibility to request approved accommodations each semester and
to meet with a DRC Counselor if any changes or additional accommodations are needed. I will
also notify the DRC Office if I change my class schedule.
Course Name
Disability Resource Center
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Disability Resource Center (Norco College)

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Completed 2 February 2021

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