University of Wisconsin-Stevens Point Office of Disability Services (715)346-3365
Accommodations Request
Student
Date
Course Name & No.
Instructor
This student has provided the university with required documentation of a disability. Based on that
documentation the following accommodation(s) is/are appropriate.
Classroom Accommodations:
___ Tape recording of lectures ___ Scribe ___ Reader ___ Preferential Seating ___ Enlarged Copies
___ Note-taker (Please request a volunteer note-taker, self duplicating paper will be provided by the student)
___ Sign Language Interpreter ___ Closed Caption Videos
___ Other
Exam Accommodations:
___ Additional time (Time and a half is standard for exams unless otherwise indicated)
___ Distraction free environment
___ No penalties for spelling on impromptu writing and essay questions (If accuracy of terms is critical,
please meet with the student following the exam to clarify any questions.)
___ Scribe
___ Reader
___ Calculator
___ Computer
___ Oral or Tape Recorded
(For Essays)
___ Text to voice
___ Enlarged copies ___ Other
Exam Administration Preference: (Instructor Preference or Disability Services Recommendation)
___ Exam administered in Instructor’s area (Please mark here if you are able to provide the test accommodations)
___ Proctored exam (If you would like Disability Services to administer and/or monitor the exams, please mark here
and inform the student. It is the student’s responsibility to notify the DS office at least 5 school days prior to exam
so we can arrange administration with you – weekends are not included in the 5 day notice. Disability Services will
then contact you prior to exams for arrangements.)
Notes:
Jim Joque, Disability Services Coordinator
or
Andy Held, Disability Services Advisor
************* ******************** **********************
The above named student and I have discussed these accommodations.
Instructor
Date
If you have questions or concerns, please contact the Office of Disability Services at 715-346-3365
TTY/TDD: 715-346-3362 or email jjoque@uwsp.edu or aheld@uwsp.edu
Instructors - please retain the white copy for your files.
White Copy – Instructor
Yellow Copy – Disability Services
Pink Copy – Disability Services – Student File
(07/08)