The Office of Disability Services (ODS) arranges academic accommodations for qualified
students with disabilities. Accommodations may include academic tutorial assistance, possible
examination-related accommodations such as extended time or a distraction-reduced
environment or possible extended time with assignments. Students seeking academic
accommodations will first need to fill out this RAF form.
PLEASE NOTE: This from must be filled out PRIOR to the first full week of school/courses to
formally request accommodations.
Last Name______________________________ First Name______________________ MI____
SCU ID#________________________ Date of Birth________________ Gender: M F
Cell phone (___)__________________ Email address_________________________________
Please Check the Program you are enrolled in:
___Traditional ___Adult Studies ___Online Studies ___Graduate Studies
What is the nature of your disability?
___Specific Learning Disability ___Visual ___Hearing ___Physical/Medical ___Temporary
Have you previously received accommodations and/or services? ___Yes___ No
If yes, when/where did you receive services?__________________________________________
School year you are requesting accommodations for? Fall 20__ Spring 20__ SU 20___
PLEASE NOTE: SCU requires documentation of your disability. Once the appropriate
documentation is received, the process can take up to three weeks to review and determine if you
are eligible for accommodations. If you have questions regarding documentation guidelines,
please contact the Center for Student Success at 405-470-7942.
Student Signature__________________________________________ Date________________
Policy Revised: Fall 2014