• Request for Accommodations

    Enter your identifying information below

  • NOTE: This form must be completed by the student.

    Students who have conditions that preclude them from completing this form may request assistance through Student Accessibility Resources (SAR) by contacting the Accessibility Specialist by -

    • email -  sar@wvstateu.edu
    • phone - 304-766-3083
    • text - 681-533-0850
    • office - 123 Sullivan Hall East, M-F, 8:30a-5:00p
  •  -
  •   CRN Course Prefix (BIOL, MATH, ENGL, etc) Course Number & Section Faculty's Name Want accommodations for this class? (YES/NO) Notify faculty you have accommodations? (YES/NO)
    Course 1
    Course 2
    Course 3
    Course 4
    Course 5
    Course 6
    Course 7
    Course 8

  • Condition and Documentation


  •   YES NO
    Did you have an IEP or 504 plan in middle or high school?
    Have you seen a diagnosing and/or treatment professional for your impairment in the last five years?
    Have you had an evaluation for your impairment within the last five years?
    Are you currently a client of the WV Division of Rehabilitation Services or comparable agency in your home state?

  • Temporary Accommodations - to request accommodations on a temporary basis, complete the questions below and submit appropriate, supporting documentation.

  • Types of Accommodations

    Indicated below are the types of academic adjustments/accommodations in which you might be interested. Please note this in no way is an indication of what may ultimately be determined as approved for you, but are merely suggestions of the types of accommodations that may have worked for you in the past and/or may be available to you at WVSU. For each of the following areas, check all accommodations and services options in which you are interested:

  • Current Issues - Indicate if any of the below are current issues for you












  • Description of Disability, It's Impacts and Challenges You May Face in the College Environment

  • Accommodations

    Indicated below are the types of academic adjustments/accommodations in which you might be interested. Please note this in no way is an indication of what may ultimately be determined as approved for you, but are merely suggestions of the types of accommodations that may have worked for you in the past and/or may be available to you at WVSU. For each of the following areas, check all accommodations and services options in which you are interested:








  • Approved Accommodation Requests

    If you have previously been approved for any of these accommodations, you may make the request to utilize these accommodations for the upcoming/current semester here.
  •   YES NO
    I understand that I must submit requests for testing with SAR at least 3 business days in advance of the test.
    I understand that I will be scheduled at the SAR Testing Center according to availability of space.
    I understand that all tests are to be taken at the same time the class is scheduled to take the exam unless I have the approval of the faculty to test at another time.
    I understand that all testing rooms are monitored by video and in-person.
    I understand no electronic devices, books, notes or other aids are allowed in the testing room without the consent of the faculty.
    I understand my belongings will be locked in the SAR Testing Center closet before I enter the testing room and returned once I complete and return the test to SAR staff.

  • You will enter your test information and dates by using the following link - 

    https://sar-testingcenter.youcanbook.me/

    Return to this page when you are finished entering the test information.

  •   Class Faculty Name Date Exam Scheduled Time Exam Scheduled
    Test 1
    Test 2
    Test 3
    Test 4
    Test 5
    Test 6
    Test 7
    Test 8
    Test 9
    Test 10

  • Digital/Electronic/Alternative Textbook Request

  •   YES NO
    I understand I must allow 2 weeks to obtain digital textbooks because they are dependent on publisher's approval and availability.
    I understand although I may prefer one format over another, SAR does not have control as to which format will be available from the publisher.
    I understand there may be times when some text will not be available in an electronic/alternative format and that I must allow a reasonable time frame in order for SAR to request permission from the publisher and produce an alternative textbook version.
    I understand that I must provide proof of possession of the textbook before a digital/alternative textbook can be provided.
    I understand all digital/alternative textbooks must be returned to SAR by the last day of the semester and that if I fail to do so, a hold will be placed on my account. This hold will not be removed until I have returned the digital/alternative textbook in the same condition as I received it.
  •   Course and CRN/Section Textbook Title ISBN Textbook Year
    Textbook 1
    Textbook 2
    Textbook 3
    Textbook 4
    Textbook 5
    Textbook 6
    Textbook 7

  • Note Taking Accommodations

  •   YES NO
    I understand that the faculty will receive notification from the SAR and that it is also my responsibility to contact each faculty member before using a recording device to inform him/her that a device will be used in class.
    I understand that information contained in the recorded lecture is protected under federal copyright laws and may not be published without the consent of the lecturer.
    I agree that I will not share, send, post publish, make public, or duplicate any recordings without the written authorization of the recorded person(s).
    I understand that failure to abide by these rules may render me liable to the faculty member and members of the class for breach of privacy and violation of copyright laws.
    If using a recording device for note-taking, I agree that recording classes is permissible solely to facilitate my note-taking accommodation and for no other purpose.
    I agree to destroy my recording of any classes at the end of the semester. If my recording is for a class that I need to refer to in the future, I agree to destroy my recording at the completion of any courses that are dependent on this course.
    I understand that failure to abide by these rules is considered a serious violation of West Virginia State University standards and subject to disciplinary action.
  •   YES NO
    Do you want your identity to remain anonymous/confidential from the peer note taker?
    I understand that if I am requesting that my identity remain anonymous/confidential, it may take longer to identify and obtain a note taker.
  •   CRN Course Number & Section Class Name
    Course 1
    Course 2
    Course 3
    Course 4
    Course 5
    Course 6
    Course 7
    Course 8

  • Current Issues


  • Submission Page

  • By submitting this form and typing my name below, I affirm that I - 

    • am a student at West Virginia State University
    • have personally completed this form in it's entirety
    • have provided accurate and complete information regarding myself
  • Should be Empty: