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Students will complete this form when requesting and/or renewing their academic accommodation request.


Form Information

  • Students may complete the Accommodation Request Form here or by accessing it on the Access and Accommodations Resource Center (AARC) homepage, located on the University website. 
  • Click on the link to open the form.

Student Information - Page #1

  • The student will complete the following student information on page #1: 
    • Date
    • Student ID#
    • Student Name
    • Preferred Name
    • Preferred Pronoun
    • Student Email
    • Academic Year
    • Student Disability

Accommodation Request - Page #2

  • Page #2 of the form addresses the accommodations:
    • I am requesting academic accommodations at Valparaiso University for the first time.
    • I want to renew previously approved accommodations
  • The logic on the form is built to respond to your answer to the last question on page #2.
    • If you are requesting academic accommodations for the first time, the form will take you to page #3
    • If you are renewing or updating academic accommodations, the form will skip page #3 and take you directly to page #4. 

New Request Support Documents - Page #3

  • Page #3 is a new request support document page. It will ask you to list the accommodations that you are requesting, then identify the documentation that you are submitting in support of your request: 
    • You will then be able to select the file(s) that you have saved on your computer.
    • You may upload multiple files. 
    • Once done, click continue
    • Provider's Note on Official Letterhead; letter must state disability and effects on major life activities or copy of evaluations
    • 504 plan /IEP
    • Copy of evaluation
    • I have already provided documentation to AARC
    • Other
    • It will then ask you to upload the documents. To do so, click on the "Select Files" button

Renewal Request Support Documents - Page #4

  • Again, if you are renewing/updating your accommodation request, the form will automatically skip page #3 and take you to page #4. This page is a support document page for accommodation renewals and/or updates.
  • It will ask you to list each accommodation that you are requesting.
  • Then you will be able to upload any documentation that you like AARC to add to your file.
  • Finally, you will need to give a rationale for newly requested or modified accommodations.

Consent Approval - Page #5

  • Page #5 is the Consent page. It's important to note that if you desire to change approved consent, you must make that request in writing.
    • Permission to communicate accommodations and specific needs to university personnel ( i.e. faculty & staff), when appropriate.
    • Permission to discuss accommodations and academic performance with parents and/or guardians, if appropriate. Parents or guardians must initiate contact.
    • Permission to communicate with medical personnel with knowledge of your individual situation.
    • The first section is where you will check each box to which you are providing your approved consent. 
    • The second section is where you will provide your electronic signature, either typed or drawn. 
    • The third section is just a spam protection for the form, simply answer the question.
    • Then click continue

Review Page - Page #6

  • The last page is a review page, it allows you to review all of your information prior to submission.
    • If you need to make any corrections, click on "previous" to take you back to the page that needs the correction. 
    • Once you make the correction, simply click "continue" until you reach the review page again.

If all of the information is correct, click the "Submit" button. Once you submit your form, you will receive a message letting you know that your form has been successfully submitted.

Your request will be reviewed and you will be notified within 72 hours of any necessary followup. It is important to remember that just because you submit a form, does not mean that it is approved. Your accommodation(s) MUST be approved by the AARC. Please contact the Access and Accommodations Resource Center if you have any questions and/or concerns: 




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