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Request For Accommodations Consent Form Final

This document is a request for accommodations consent form for students taking Advanced Placement or Cambridge International exams. It provides two options - declining accommodations or consenting to the school releasing records to document a disability and need for accommodations. By signing, the student agrees to conditions in the student bulletins and understands additional applications may be required. The form must be returned by December 3rd and will be kept on file at the student's school.

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305 views1 page

Request For Accommodations Consent Form Final

This document is a request for accommodations consent form for students taking Advanced Placement or Cambridge International exams. It provides two options - declining accommodations or consenting to the school releasing records to document a disability and need for accommodations. By signing, the student agrees to conditions in the student bulletins and understands additional applications may be required. The form must be returned by December 3rd and will be kept on file at the student's school.

Uploaded by

api-559862109
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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School District of Palm Beach County, Florida

REQUEST FOR ACCOMMODATIONS CONSENT FORM


For
College Board’s Advanced Placement and
Cambridge Assessment International Education

Student’s Name: ___________________________________ Student’s Date of Birth: __________________

School: Palm Beach Lakes Community High School

Option 1:

_______ I would like to decline any testing accommodations for College Board Advanced Placement and
Cambridge International Examinations

Option 2:

_______ I wish to apply for testing accommodation(s) on either College Board Advanced Placement or
Cambridge AICE AS/A level exams. I authorize my school, __________________________ ______________,
to release to the College Board Advanced Placement and/or University of Cambridge International
Examinations, copies of my records that document the existence of my disability and need for testing
accommodations; to release any other information in the school's custody that College Board Advanced
Placement and/or University of Cambridge International Examinations, requests for the purpose of
determining my eligibility for testing accommodations; and to discuss my disability and accommodation
needs with both organizations. I also grant the College Board Advanced Placement and/or University of
Cambridge International Examinations permission to receive and review my records, and to discuss my
disability and needs with school personnel and other professionals. I agree to the conditions set forth in the
student bulletins for the College Board Advanced Placement and/or University of Cambridge International
Examinations relating to accommodations for disabilities.

Please read thoroughly and initial:

______ I would like to apply for accommodations with either College Board Advanced Placement and/or
University of Cambridge International Examinations. I understand that it requires an additional application
to be filled out by me and will be evaluated by either College Board or Cambridge Assessments.

Note: College Board Advanced Placement and University of Cambridge International


Examinations may require additional documentation to be attached to the application, other
than the 504 or IEP packet.

__________________________________________________ ____________________________
Student’s Signature Date

__________________________________________________ ____________________________
Parent /Guardian’s Signature (Required if Student is under 18) Date

Please return this completed form to the school no later than December 3, 2021.

Instructions to the School:


This form must be used when a request for accommodation(s) is submitted electronically. The form should be maintained by the
School with the student’s records. It does not need to be sent to either the College Board or University of Cambridge. You will be
asked to verify that Consent Form is on file at the school prior to submitting a request for accommodations.

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