Request for Student Accommodations

Request for Student Accommodations





 

CHECKLIST

Apply to Lake Land College by completing the Intent to Enroll.

Complete all sections of this application packet.

Submit this application at least six (6) weeks before the start of the semester you plan to enroll. If the Office of Student Accommodations does not receive a completed application and documentation at least six (6) weeks prior to the start of the semester, some request services may not be available at the start of the semester.

Provide documentation. Documentation can include: (1) a school IEP or 504 Plan; (2) a physician's letter; (3) a psychological evaluation; and/or (4) documentation as determined during the  application meeting.

Schedule an appointment with the Office of Student Accommodations. This appointment is to discuss your specific accommodations and answer any questions or concerns you may have. This meeting is required before your accommodations are officially registered.

Follow through with your requested accommodations. It is your responsibility to discuss your requested accommodations with your instructors.


Approved Accommodations


No Yes
If yes, please check below the accommodations you have previously received:

AUDIOBOOKS ONLINE

TEST READER

EXTENDED TIME FOR TESTING

NOTE TAKER

SCRIBE

TAPE RECORD LECTURES

ALTERNATE TEST SETTING

LARGE PRINT MATERIALS

BRAILLE MATERIALS

SIGN LANGUAGE INTERPRETER

ACCESSIBLE SEATING

SPECIAL EQUIPMENT

ATTENDANCE

TUTORING

* Accommodations are determined on supporting documentation and on an individual student-need basis. Previously qualifying for accommodations in high school or college does not translate into automatic accommodations at Lake Land College.

Lake Land College, is committed to creating and continuously improving an affordable, accessible and effective learning environment, provides reasonable accommodations for students with a documented disability. The faculty and staff at Lake Land College work to address learning barriers in order to help students reach their lifelong educational goals. The Accommodations office at Lake Land College follows the guidelines of Section 504 of the Rehabilitation Act and Americans with Disabilities Act of 1990.

DOCUMENTATION SUMMARY

What is the first semester you are requesting accommodations? (ex. Fall 2021, Spring 2022)


No Yes

During what year were you last enrolled


No Yes

My disability falls into the following category:

LEARNING

PSYCHOLOGICAL

LEARNING ADHD

AUDITORY

HEALTH/PHYSICAL

MOBILITY

VISUAL

SPEECH/LANGUAGE

MULTIPLE

TBI

Additional details:

EDUCATION

MAJOR/ACADEMIC PROGRAM:

OVERALL EDUCATIONAL GOAL:

PERSONAL OR DEVELOPMENTAL

NO SPECIFIC GOAL

JOB

CERTIFICATE IN

ASSOCIATE DEGREE IN

BACHELOR'S DEGREE

MASTER'S DEGREE

DOCTORATE

TRIO STUDENT SUPPORT SERVICES
TRIO is a one-on-one academic support program with the sole purpose of helping students in need to succeed in college. TRIO works with students that are first generation college students, income eligible or registered with Accommodations.

Current TRIO Student

Applied for TRIO

Need more information on TRIO

ELECTRONIC SIGNATURE/SPAM QUESTION

ELECTRONIC SIGNATURE
By checking this box, this will be your electronic signature acknowledging that you have read and agree to the information stated above.

Questions regarding this request please contact Lake Land College Office of Student Accommodations
at 217-234-5259 or email us at aniebrugge71503@lakelandcollege.edu.