REQUEST FOR ACADEMIC ACCOMMODATIONS

Ranken Technical College is committed to following the American with Disabilities Act (ADA) signed into law in 1990. The Americans with Disabilities Act is the nation’s first comprehensive civil rights law for persons with disabilities. Please complete the form below to begin the accommodations process. After completing the form, attach any relevant documentation--Individual Education Plan (IEP), 504 Plan, letter from healthcare provider for review. A member of the accommodation team will reach out to you via phone call, text, or email to schedule an accommodation meeting once the form has been completed and the documentation has been submitted. Please respond to this correspondence as soon as possible. Note: All submitted information, including diagnoses, is confidential and only shared with the accommodation team to assist with composing the accommodation memo.

First Name *

Last Name *

Email *

Telephone *

Campus (Location) *

In which division, day or evening, are you enrolled?

Day

Evening (ONLY Ranken - St. Louis offers programs in the evening division). Other locations offer day programs during the evening time period.)

Will you live on campus in Walker Hall? *

Have you started classes? *

If yes, what semester are you enrolled in now?

If you have not started classes, when will you begin? +

Preferred Contact Method *

Telephone

Email

Other Other

Comments/Special Considerations:

Would you like information about a referral for disability diagnosis/assessment? *

Yes

No

Unsure Unsure

Submit your documentation here.