Fundamental Alteration Form

Please complete this form to notify Disability Resource Center staff that a requested accommodation would fundamentally alter an essential requirement or objective of a course or academic program.

Instructor name(Required)

First Last

Instructor email(Required)

Instructor phone(Required)

Department(Required)

Semester (e.g. Spring 2020)(Required)

Course number (e.g. MUEN 4113(Required)

Course title (e.g. Concert Choir)(Required)

To which accommodation are you referring?(Required)

What fundamental course objective does this accommodation alter?(Required)

What practical function does this fundamental objective serve in the academic program?(Required)

How does the accommodation alter this fundamental course objective?(Required)

Is there any alternate way the student could demonstrate competence without undermining the essential course objectives? For example, an alternate accommodation that would not alter the essential objective of the course or program.(Required)

Please provide documentation of the fundamental course objective (e.g. syllabus, professional association certification requirement, technical standard, etc.)

Max. file size: 49 MB.

Final questions

Has this accommodation been provided to students without disabilities or for any other situation or reason in your class in the current semester or in the past? Why?(Required)

Anything else you'd like the DRC to know?

Fundamental Alteration Form

Final questions

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