Accessibility Services Extension Request Form Feb 13, 2020 Name: * Required First Last Email: * Required Student number: * Required Select accessibility advisor: * RequiredAlexa KirklandAmanda KurgatnikovBethany CleghorneBrittany Van BeilenCandace ChanCarrie ClaytonCathy YuElizabeth JeffreyGretel SilvestreIrene SullivanJordana BengallKrysta HalliwellLeanna ShadeMary DamianakisMaryam MasoodMichael MercerNicole RanieriPearl LeveySabrina PagliaSara GoldSara WojciechowskiSamahra ZatzmanSarah Goodfield WeinsteinSezgi OzelShayna GoldbergSimon NnaakiryaSuzanne HornSuzette McLartyTeresa WooVivian ZhangVivien ChanCourse code and section: * Required e.g. BIO120H1-FProfessor/instructor’s name: * Required First Last Professor/instructor's email: * Required TA's name: First Last TA's email: Name of the assignment: * Required e.g. lab report #2, annotated bibliography, major paper, etc.Original due date of assignment: * Required MM slash DD slash YYYY Weight % of the final grade: * Required What interactions have you had with your professor or TA about this assignment? * RequiredHave you met other deadlines in this course? * Required Yes No Mostly Have you been regularly attending and participating in the course? * Required Yes No Mostly Have you already requested an extension? * Required Yes No If you selected yes and an extension was granted, what is the new submission date? * Required MM slash DD slash YYYY What are the disability-related issues or factors that have made submission of this assignment difficult? * RequiredYour proposed new submission date for the assignment is: * Required MM slash DD slash YYYY Additional information and documentationBy 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. Freedom of Information and Protection of Privacy Act * Required I agree to the privacy policy.The University of Toronto respects your privacy. Personal information that you choose to provide voluntarily to the University is collected pursuant to section 2(14) of the University of Toronto Act, 1971. It is collected for the purpose(s) of program administration. At all times it will be protected in accordance with the Freedom of Information and Protection of Privacy Act. If you have questions, please contact accessibility.services@utoronto.ca.
