SAMPLE NOTIFICATION LETTER
Student Accommodations and Resources
Instructor Notification of a Section 504/ADA Accommodation
Fall/Spring/Summer 20__ - 20__
John Doe
1215 Houbolt Rd.
Joliet, IL 60431
John Doe, 1234567
Has been identified as a student with a documented disability as defined by the Americans with
Disabilities Act (ADA). The disability affects a major life area; therefore, it qualifies the student
for accommodations in compliance with ADA and Section 504 of the Rehabilitation Act.
It is your responsibility as the student’s classroom instructor to provide this student with the
accommodations to which he/she is entitled under Section 504 and the ADA. This student is
entitled to the accommodations listed below preceded by the phrase “Required
Accommodations”.
Items listed below that are preceded by the phrase “Learning Style” provides additional
information that may help you in understanding the student’s learning style or disability. Some
of these accommodations have been arranged by the Student Accommodations and Resources
Department prior to the semester.
Required Accommodation…..Extended test time
Required Accommodation…..May need test read or questions rephrased
Required Accommodation…..Notetaker needed if you receive blue form
Learning Style……Deaf
Learning Style……individual health concern
Examples
Examples
Comments:
___________
In addition to the required classroom accommodations, this student may choose to utilize
academic support services from Student Accommodations and Resources (StAR).
This notification is authenticated by the embossed seal. Please contact Student Accommodations
and Resources at (815) 729-9020, ext. 2230 for additional information. Instructors may make
copies of this document after determining the validity of the notification.
Student Accommodations and Resources Office-Joliet Junior College