Home - Owens Community College



Campus Toledo Rep: Theresa Capra-Roberts

Findlay Sue Emerine

ALC Kurt Soltman

Source

Workforce

Name       Semester      

OCID #       Date      

Phone #      

PLEASE CHECK THE LETTER OF EACH REQUESTED ACCOMMODATION.

|1. CRN # |Course |Number |Section |

|      |    |     |    |

|Course Start Date |      |

Requests: Web Course

| A. 1½ Time | B. Double Time | C. Tests/Quiz - Alt Format |

| D. Text - Alt Format | E. Notetaking | F. Enlarged Materials |

| G. Interpreter | H. Scribe | I. Reduced Distraction |

| J. Computer | K. Calculator | L. Tape – Lectures |

| M. Transcription | N. FM System | O. Other (List) |

|2. CRN # |Course |Number |Section |

|      |    |     |    |

|Course Start Date |      |

Requests: Web Course

| A. 1½ Time | B. Double Time | C. Tests/Quiz - Alt Format |

| D. Text - Alt Format | E. Notetaking | F. Enlarged Materials |

| G. Interpreter | H. Scribe | I. Reduced Distraction |

| J. Computer | K. Calculator | L. Tape – Lectures |

| M. Transcription | N. FM System | O. Other (List) |

|3. CRN # |Course |Number |Section |

|      |    |     |    |

|Course Start Date |      |

Requests: Web Course

| A. 1½ Time | B. Double Time | C. Tests/Quiz - Alt Format |

| D. Text - Alt Format | E. Notetaking | F. Enlarged Materials |

| G. Interpreter | H. Scribe | I. Reduced Distraction |

| J. Computer | K. Calculator | L. Tape – Lectures |

| M. Transcription | N. FM System | O. Other (List) |

DATE RECEIVED       DATE PROCESSED      

LETTER PRINTED      

|4. CRN # |Course |Number |Section |

|      |    |     |    |

|Course Start Date |      |

Requests: Web Course

| A. 1½ Time | B. Double Time | C. Tests/Quiz - Alt Format |

| D. Text - Alt Format | E. Notetaking | F. Enlarged Materials |

| G. Interpreter | H. Scribe | I. Reduced Distraction |

| J. Computer | K. Calculator | L. Tape – Lectures |

| M. Transcription | N. FM System | O. Other (List) |

|5. CRN # |Course |Number |Section |

|      |    |     |    |

|Course Start Date |      |

Requests: Web Course

| A. 1½ Time | B. Double Time | C. Tests/Quiz - Alt Format |

| D. Text - Alt Format | E. Notetaking | F. Enlarged Materials |

| G. Interpreter | H. Scribe | I. Reduced Distraction |

| J. Computer | K. Calculator | L. Tape – Lectures |

| M. Transcription | N. FM System | O. Other (List) |

|6. CRN # |Course |Number |Section |

|      |    |     |    |

|Course Start Date |      |

Requests: Web Course

| A. 1½ Time | B. Double Time | C. Tests/Quiz - Alt Format |

| D. Text - Alt Format | E. Notetaking | F. Enlarged Materials |

| G. Interpreter | H. Scribe | I. Reduced Distraction |

| J. Computer | K. Calculator | L. Tape – Lectures |

| M. Transcription | N. FM System | O. Other (List) |

|7. CRN # |Course |Number |Section |

|      |    |     |    |

|Course Start Date |      |

Requests: Web Course

| A. 1½ Time | B. Double Time | C. Tests/Quiz - Alt Format |

| D. Text - Alt Format | E. Notetaking | F. Enlarged Materials |

| G. Interpreter | H. Scribe | I. Reduced Distraction |

| J. Computer | K. Calculator | L. Tape – Lectures |

| M. Transcription | N. FM System | O. Other (List) |

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