Request for Academic Accommodations
The Accessibility Office
Section I: Student Information (Please type information or print legibly)
Student Name:
Last
First
Middle
Student ID:
Cell Phone:
Your Faculty Accommodation Memo will be emailed to your Bucks email account.
Section II: Course & Semester Information
Academic Year:
Fall
Winter
Spring
Summer I
Summer II
Summer III
Courses for indicated semester: Please include course and section numbers (Example: MATH 095-N10)
#1
#2
#3
#4
#5
#6
#7
#8
#9
#10
PLEASE NOTE:
If this form is incomplete, it will delay completion of your FACULTY MEMOS. If you have registered with TAO and would
like academic accommodations, you are required to complete the Request for Academic Accommodations every semester.
Requests do not automatically carry over to the next semester.
Student Signature
Date
**See back of page for Important Instructions**
Newtown Campus • Student Services Center • Rollins Building • 275 Swamp Road • Newtown • PA • 18940
(215) 968-8182 • (215) 968-8033 fax • accessibility@bucks.edu • http://www.bucks.edu/student/accessibility/
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Request for Academic Accommodations 2
Process to Receive Academic Accommodations
A. A student with a documented disability that limits his or her ability to function in the college learning environment
may request academic accommodations.
B. Accommodations are provided to students based on their specific documentation, disability and needs.
C. Students need to follow these steps:
1. Speak with and provide appropriate documentation of diagnosed disability and need for accommodations to a
Learning Disability Specialist in the Accessibility Office.
2. Complete the Request for Academic Accommodations after you register for classes OR at least two weeks before
classes begin. Late requests will be handled as they are received.
a. TAO staff will tell you if your request is accepted or denied and the reason why.
3. Faculty Memos will be provided to you by TAO, via your Bucks email address, stating the accommodations for
which you are eligible and how to provide them.
4. Students should meet with their instructors during the first week of classes and
a. Give them your Faculty Memo via their Bucks email to ensure that the professor has received an official
communication from the students
b. Discuss the accommodations on the form with them
c. Accommodations do not go into effect until the faculty memo is provided to the instructor
d. Accommodations are not retroactive.
1) Accommodations are provided to the students in classes once the instructor is provided with a copy of
the faculty memo.
2) It is the responsibility of the student to communicate with the professor as soon as possible about their
accommodations and provide them with the faculty memo.
5. Students are urged to contact TAO Staff at any time, especially if accommodations are not being provided.
6. If you have registered with TAO and would like academic accommodations you are required to complete the
Request for Academic Accommodations every semester. Requests do not automatically carry over to the next
semester.
Important Reminders:
Instructors are required to comply with College policies regarding accommodating students who follow this process.
Instructors are not required to make accommodations without a Memo from TAO.
Communicating with your instructor regularly often helps to create a positive relationship for working together.
Consider contacting your professors even before the semester starts.
Contact the TAO Office if there are any questions or concerns during the semester.
The TAO staff will not discuss a student’s disability with an instructor unless the student provides us with permission.
I have read and understand the above information:
Student Signature
Date
Bucks County Community College does not discriminate in its educational programs, activities or employment practices based on race, color, national origin, sex, sexual
orientation, disability, age, religion, ancestry, veteran status, union membership, or any other legally protected category.
Bucks County Community College The Accessibility Office
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