(Returning Student) Renewal of Accommodations

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(Returning Student) Renewal of Accommodations

This form is for returning students who had accommodations at Malone University in a previous semester and wish to renew those accommodations for the upcoming semester.

First Name: *

Last Name *

Malone 6 digit student ID: *

Malone email address: *

For which semester/year are you requesting accommodations? *

Please select one response regarding your situation: *

I wish to continue using the same accommodations that I had last semester/year.

I no longer need accommodations and want to decline them at this time.

I would like to change/update my accommodations and need to meet with the Director of Accessibility Services. (If you choose this option, the Accessibility Services Coordinator will reach out to you to set up a meeting at the beginning of the semester).

Other:

If you have selected to renew your accommodations from last semester, please list those previously approved accommodations below. If there are any discrepancies with your information, the Accessibility Office will contact you to set up a meeting. *

If you have any additional questions or concerns for the Accessibility office, please list them below. If you have none, please type N/A. *

By typing my name below, I am certifying that all responses are true and accurate. Information provided is considered part of your educational record and is covered under FERPA (Federal Family Education Rights and Privacy Act). *

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