Instructor's NameJill Mateo
Instructor's e-mail
Course Registration Number (CRN)21500
Specify the length of time that the agreement will be in effect:current quarter

Section A: Excused Absences/Make-up Participation Points

Using the Attendance and Flexibility Consideration Rubric, I have determined that:absences beyond the number allowed in the syllabus is not a reasonable accommodation. Additional information is required.
The maximum number of excused absences without penalty permitted:
Additional details or exceptions to allotment:
Plan for make-up participation points, if applicable (e.g. .submit additional blog posts on Canvas):
Please explain why absences beyond the number allowed in the syllabus is not a reasonable accommodation.There is significant interaction between the instructor and students during the class meeting (e.g., discussion, interactive experiences, problem solving). There is significant classroom interaction among students during the class session - it is a discussion-based seminar. A fundamental learning objective relies on active student participation during the class meeting - 40% of grade comes from participation. The student’s absence or variable attendance will constitute a significant loss of the educational experience for the student and/or classmates - much learning in this course happens in-class.

Section B: Deadline Extensions for Assignments

Important Notice to Students: The consequences outlined for the class for missing the deadline applies to the adjusted deadlines for the student using this accommodation.
Using the Deadline Extensions Consideration Rubric, I have determined that:deadline extensions is not a reasonable accommodations. Additional information is required.
Applicable assignments (check all that apply):
List any assignments that are not approved for deadline extensions
If applicable, please detail the notification plan for requesting assignment extensions.
Please explain why deadline extensions beyond the number allowed in the syllabus is not a reasonable accommodation.If an assignment is not completed by the deadline, the student will be unprepared to fully participate in classroom discussion.
If the assignment is not completed by the deadline, there be a direct impact on the learning experience for the student, as discussion is an integral part of the course and weekly papers submitted prior to class ensures students are informed and prepared to discuss. Meeting assignment deadlines constitutes a learning objective of the course (see above). An additional day or two extension will alter the purpose and ability to grade the assignment.

Section C: Make-up Quizzes/Exams

I have determined that administering a make-up quiz/exam is:not applicable in the course.
Timeframe for Make-Up Quizzes/Exams (select one):
Specify the number of business days:
Specify the date:
Proctoring of the make-up quizzes/exams (select one):
Student responsibilities when using these accommodations:

  1. To use these accommodations for disability-related reasons only and to maintain prompt and regular communication with the instructor.

  2. To contact the instructor and SDS if unable to meet the terms of this agreement.

  3. To be responsible for meeting the policies in the course syllabus and the essential requirements of the course, as is required by all other students enrolled in the course.

  4. This agreement becomes effective when sent to the student by SDS. The terms of this agreement are not retroactive to previous course requirements.

User ID
Scroll to Top