16007 Crenshaw Blvd., Torrance, CA 90506, EOPS Office Phone: 310-660-3466
Complete forms should be emailed to eopsoutreach@elcamino.edu.
EOPS & SRC Referral Form – Revised 11/2/2020
Extended Opportunity
Programs & Services
EOPS & Special Resource Center
Inter-Program Referral Form
Student’s Name: _______________________________ ECC ID Number: _____________
Student applying to EOPS for Term/Year: Spring 2021 Referral Date____________
The Ext
ended Opportunity Programs & Services (EOPS) regulations require students to
be full-time (12 units) to be eligible for the EOPS program. Guidelines have been
established to make academic accommodations for students with a disability that limits
enrollment to less than full-time. A student having a disability, which limits their
enrollment to less than nine units, but otherwise meets the eligibility criteria for EOPS,
may be accepted into the EOPS program after verification of this limitation by the
appropriate certificated Disabled Student Programs and Services (DSPS) staff. The DSPS
office at El Camino College is called the Special Resource Center (SRC). EOPS will refer
students to SRC to obtain disability verification. The SRC staff must verify that the student
has a disability and establish the acceptable full-time unit coursework load for the
student based on that disability. This information will be kept in the student’s EOPS file.
Please note that participation in SRC is completely voluntary. The term of acceptance
into the EOPS program is the only time that the SRC program must report information on
a student who does not participate in the SRC program.
STUDENT AUTHORIZATION for EOPS and SRC to exchange information:
_______________________________________ _____________________________
Student Signature Date
SPECIAL RESOURCE CENTER USE ONLY:
Disability Status Verification on File
Recommended Academic Unit Load: _________ for Term
/Year Spring 2021
(IMPORTANT-Term/Year must match the term for which the student is applying to EOPS)
_______________________________________ _____________________________
SRC Staff Signature Date
click to sign
signature
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signature
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