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This application should be used by students for all accommodation requests including academic/learning, housing, dining and workplace accommodations. The applicant must complete and submit the online form below and must also supply appropriate documentation to Student Disability Services.

Documentation guidelines for specific disability types and submission instructions are found at https://my.graceland.edu/ICS/Resources/Student_Disability_Services. Please choose the correct guideline based on the nature of the disability.

Upon receipt of a completed application, Student Disability Services will contact the applicant to set-up an appointment to discuss the application and the outcome of the review. Please note that completing this application does not guarantee the approval of any accommodation.

Reasonable and appropriate accommodations, academic adjustments, and/or auxiliary aids and services are determined on a case-by-case basis for otherwise qualified individuals who have a demonstrated need for these services and can provide appropriate documentation.

Name*
MM slash DD slash YYYY
Address
Campus (choose one)*

FUNCTIONAL IMPACTS

Please choose the severity of impact of the following tasks.
Attention/concentration
Taking notes
Starting, organizing and completing tasks
Interacting with others
Following verbal directions
Following written directions
Seeing
Hearing
Understanding visual information
Memorizing information
Understanding auditory information
Putting thoughts into writing
Using my hands
Speaking clearly
Sitting for long periods
Moving around (standing/walking)
Tolerating stress
Motivation
Finishing tests on time
Spelling
Writing
Reading at a standard rate
Understanding what I read
Doing math calculations
Studying
Other (please list in comments below)
Other (please list in comments below)
Other (please list in comments below)

ACCOMMODATIONS

Please check all that apply to your request:
Please include the nature of your disability, a description of all current limitations and the specific accommodations that you are seeking. Include any relevant history regarding your disability, past accommodations that were helpful to you and other information that you feel would be helpful.

OUR COMMITMENT

Graceland University is committed to ensuring that educational opportunities, programs and services offered by the University are available and accessible to all individuals in accordance with Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990 as amended in 2008 and the Fair Housing Act. As part of the implementation of these laws, the University will continue to provide reasonable accommodations for students so they can participate fully in the University's educational programs and activities.

For questions related to the Lamoni, Iowa campus's Student Disability Services, please contact sds-info@graceland.edu or Diana Jones dianaj@graceland.edu or 641.784.5083. Student Disability Services, Newcom Student Union, Room 31, Graceland University, 1 University Pl, Lamoni, IA 50140.

For questions related to the Independence, Missouri campus's Student Disability Services, please contact Jill Whitworth, at jwhitwor@graceland.edu or call 816.423.4712. Student Disability Services, Graceland University, 1401 W Truman Rd, Independence, MO 64050.

Students requesting accommodations are encouraged to contact Student Disability Services no later than the first week of class attendance. Students are required at their own expense to provide documentation verifying need of accommodation(s).

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