Accessibility Services Extension Request Form

"*" indicates required fields

Name: *

First Last

Email: *

Student number: *

Select accessibility advisor: *

Course code and section: *

e.g. BIO120H1-F

Professor/instructor’s name: *

First Last

Professor/instructor's email: *

TA's name:

First Last

TA's email:

Name of the assignment: *

e.g. lab report #2, annotated bibliography, major paper, etc.

Original due date of assignment: *

Weight % of the final grade: *

What interactions have you had with your professor or TA about this assignment? *

Have you met other deadlines in this course? *

Yes

Mostly

Have you been regularly attending and participating in the course? *

Yes

Mostly

Have you already requested an extension? *

Yes

If you selected yes and an extension was granted, what is the new submission date? *

What are the disability-related issues or factors that have made submission of this assignment difficult? *

Your proposed new submission date for the assignment is: *

Additional information and documentation

By submitting this form, you are consenting to your Accessibility Advisor communicating directly with your professor, instructor, or TA. Your Accessibility Advisor may require you to provide additional information or documentation. The outcome of this request will be communicated to your University of Toronto (UTmail+) email address. You may need to meet with your Accessibility Advisor to discuss next steps. It is important that you continue to work on assignments to the best of your ability while an extension request is being decided. Extensions are not guaranteed.

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Accessibility Services Extension Request Form

Additional information and documentation