Accommodative Services

It is the college's policy to provide, on an individual basis, academic adjustments to students with disabilities that may affect their ability to fully participate in program or course activities or to meet course requirements.

To receive academic accommodations, students must identify the disability, provide adequate documentation of the disability by a qualified professional, and work with the ADA/504 Coordinator and LAC faculty to develop an appropriate access plan. All information provided concerning a disability is confidential and is released only as allowed by law or with consent.

First Name

Middle Name or Initial

Last Name

Birthdate

Email Address (Personal)

NCCC Student Email

Phone Number

Preferred Method of Communication

Email

Texting

Phone Call

Mail

Documentation serves as the basis for providing academic adjustments and auxiliary aids and services under the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act. The documentation must both identify a physical or mental impairment, which substantially affects a life function, and supply information identifying current functional limitations that require academic adjustments to assure equal access to the college's programs and services.
The documentation must be:

Prepared by a professional who is qualified by training and practice to diagnose and treat the impairment leading to the disability.
Typed or word-processed onto the practitioner’s or their agency’s letterhead.

Please note: Handwritten notes on prescription pads are not accepted.

Please indicate your intent to pursue accommodative services at NCCC:

I plan to upload my documents via this form

I plan to email my documents at a later date to accommodations@nccc.edu

Type of Disability

Upload Supporting Documents Below

Documents must be submitted before accommodations can be approved.

What semester & year did you begin taking classes at NCCC? (ex: Fall 2026)

Please describe your diagnosed disability (disabilities).

How does your disability impact your life as a student?

Please describe the accommodations you have received in the past.

Are you working with an outside agency? (for example, ACCES-VR or other) If so, please type the name of it here:

Consent Required: By marking the checkbox, I am giving the ADA Coordinator and the Learning Assistance Coordinator permission to advocate on my behalf with other offices on campus.

I Understand