Instructor's NameDavid A New
Instructor's e-mail
Course Registration Number (CRN)22831
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 are no allowed absences for this course.

- 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 (e.g., peer review, teamwork, group discussion).
- A fundamental learning objective relies on active student
participation during the class meeting (e.g., lab experiments, paired
language learning, performance work, clinical placement rotations).
- The student’s absence or variable attendance will constitute a
significant loss of the educational experience for the student and/or
classmates (e.g., group or paired projects, performances) and/or
cause a disturbance to course instruction.

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:students with a disability may have deadline extensions. Additional information is required.
Applicable assignments (check all that apply):papers
List any assignments that are not approved for deadline extensionsIn-class presentations of Design Projects, In-class Performances, and Theatre Production "see-by" dates.

Please specify the expectations for deadline extensions.

Assignment Type(s)Papers
Timeframe for deadline extension (select one):The assignment(s) will be due within a certain number of business days of the original due date. Additional information is required.
Specify the number of business days: To be determined mutually by instructor and student based on student's need.
Specify the revised due date:
If applicable, please detail the notification plan for requesting assignment extensions.E-mail
Please explain why deadline extensions beyond the number allowed in the syllabus is not a reasonable accommodation.

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.

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