Disability Disclosure Form
Southwestern University, in compliance with Section 504 of the Rehabilitation Act of 1973 and The Americans with Disabilities Act of 1990, recognizes that qualified students who have diagnosed disabilities including specific learning, physical, or psychological disabilities, are entitled to an equal opportunity to benefit from the educational programs of the University and that reasonable accommodations may be necessary to provide that opportunity to students with disabilities.
The Center for Academic Success coordinates services for students with disabilities. Students wishing to request accommodations from Southwestern University should:
- Complete this electronic form (or return the PDF version of the Disability Disclosure Form to the Center for Academic Success, Attn: Kimele Carter). All information about a student’s disability is considered to be confidential and will remain within the office of the Assistant Director for Advising and Access Resources.
- All students requesting accommodations must provide current (within 3 years) and age-appropriate documentation from a qualified professional. Information on appropriate documentation can be obtained by contacting the Assistant Director for Academic and Access Resources and are also available here.
- To ensure adequate time to process and discuss potential accommodations, contact Kimele Carter by June 10, 2011 (or when submitting your AES enrollment form, whichever comes first). Contact information for Kimele is: 512-863-1536 (phone) or via email at firstname.lastname@example.org.
- Accommodations are class specific and it is the student’s responsibility to request accommodations. Within the first two weeks of class, schedule an individual meeting with the Assistant Director for Advising and Access Resources to solidify final arrangements for accommodations.
- Required fields are designated with an asterisk.