Academic Accommodations Form

The Swedish Program
Academic Accommodations Form

TO BE COMPLETED BY THE OFFICE OF ACCESSIBLE EDUCATION, STUDENT DISABILITY RESOURCES & SERVICES, OR SIMILAR.

A student from your institution is studying abroad with The Swedish Program. They have indicated that they receive academic accommodation and would like to receive similar accommodations while studying in Stockholm. Please complete the form below.

Student's name*

First NameLast Name

Student's date of birth*

Date

Student's school*

Does your office have documentation on file verifying the existence of a disability which qualifies the student to receive academic accommodations?*

YesNo

Please list the academic accommodations this student is approved for and receives on-campus. *

Additional comments or notes

Your name*

FirstLast

Title

Email*

Phone Number*

Signature*