Accommodation Request Form

First Name *

Last Name *

Student ID or EUID *

Preferred Contact Method *

UNT email

Phone call

No preference

For which Learning Center program(s) do you need an accommodation? *

Academic Coaching session *

What accommodations would you like during an Academic Coaching session with The Learning Center?

A large print paper copy of the Academic Coaching packet and other resources, as necessary

An American Sign Language interpreter

Other (please describe it below)

Academic Coaching session: Other *

Please explain the accommodation you are seeking:

One-on-One Tutoring appointment *

What accommodations would you like during a One-on-One Tutoring appointment with The Learning Center?

An American Sign Language Interpreter

Other (please describe it below)

One-on-One Tutoring appointment: Other *

Please explain the accommodation you are seeking:

Drop-in Tutoring *

What accommodation would you like during a Drop-in Tutoring session with The Learning Center?

An American Sign Language Interpreter

Other (please describe it below)

Drop-in Tutoring: Other *

Please explain the accommodation you are seeking:

Math Lab *

What accommodation would you like during a visit to the Math Lab?

An American Sign Language Interpreter

Other (please describe it below)

Math Lab: Other *

Please explain the accommodation you are seeking:

Learning 101 *

What accommodation would you like during a LIVE Learning 101 workshop?

Specific seating in the room (select other to specify)

An American Sign Language Interpreter

Other (please describe it below)

Learning 101: Other *

Please explain the accommodation you are seeking:

Supplemental Instruction (SI) session *

What accommodation would you like during an SI session?

An advance copy of any electronic resources

An American Sign Language Interpreter

Other (please describe it below)

Supplemental Instruction (SI) session: Other *

Please explain the accommodation you are seeking:

SI Subjects *

For which class or classes do you plan to attend SI sessions?

SI: ACCT Classes *

SI: ANTH Classes *

SI: ASLP Classes *

SI: BIOL Classes *

SI: CHEM Classes *

SI: HIST Classes *

SI: KINE Classes *

SI: MATH Classes *

SI: MEEN Classes *

SI: PSCI Classes *

SI: PSYC Classes *

GRE Prep Course *

What accommodation would you like for the GRE Prep Course hosted in Zoom? Electronic copies of the resources are provided throughout the course, and recordings of each class are posted in the Canvas page.

A braille copy of the GRE Prep Book

An American Sign Language Interpreter

Other (please describe it below)

GRE Prep Course: Other *

Please explain the accommodation you are seeking:

Learning Center

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