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Accommodation Request and Consent Form

Name:*
Phone:*
Email Address:*
Student ID:*

I understand that upon completing this form, I am giving the Disability Support Committee of LeTourneau University consent to consider my accommodation(s) requests and discuss my documentation. Documentation of your disability must be sent to the Achievement Center at ada@letu.edu or by fax to (903) 233-4401.

I am requesting the following accommodations:*

After the Disability Support Committee has met, discussed and approved the accommodations, I consent that Academic Support can release the approved accommodations to my professors. I will be notified of the approved accommodations by the Director of Student Achievement via e-mail. I understand that it is my responsibility as a student to communicate with my professors concerning the implementation of these accommodations and not the responsibility of the professors to initiate that communication. I also understand that it is my responsibility as a student to update my requests for accommodations each semester by completing and returning the update form in a timely matter.


 All fields marked with an asterisk (*) are required.
   
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