MISSION: Northland Pioneer College provides educational excellence that is affordable and accessible for the enrichment of communities across northeastern Arizona.

OAI Accommodation Request

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P.O. Box 610 • Holbrook AZ 86025-0610 • 1611 S. Main • Snowflake, AZ 85937 
Voice: (928) 536-6246 • Fax: (928) 532-6199 • Email

This form needs to be filled out for EVERY class you need accommodations for, EVERY semester.

Please enter your NPC Student ID Number. Every student enrolled at NPC has a Student ID Number assigned when they first register for classes. FERPA rules prevent the ID number from being given out over the phone.
Your Phone Number
Enter the best number to reach you during regular business hours. In case we have a quick question, or to ask you to meet with the OAI Coordinator.

NPC's academic year is broken into three segments: fall and spring semesters and a summer session.
Example: Fall 2023, Spring 2024.

Please indicate what year you first enrolled at NPC.
Example: 2021

Primary Campus/Center

Where do you take the majority of your classes?
Please select the one NPC location where you take the majority of your classes. This is your primary campus or center.
Previous accommodations (Please select one)
Have you previously had accommodations from NPC's OAI Office? If you have applied for accommodations in the past, the OAI Office has your documentation on file.  

Please note: Accommodations are awarded based on the impact of your disability as discussed during your intake appointment. 

This form serves the purpose of notifying us of your enrollment at NPC and the classes you need accommodations in. Follow the example: in Course 1 (you can enter your own data here, as well). Enter the Course Department abbreviation and Course Number and Section Number. Enter the name of your instructor.

Sign below using your mouse, or finger on touchscreen.
Signature Required
After working with their academic adviser to complete this form, the student needs to sign - either electronically, or print out a copy and then sign, scan to email and send to the OAI Office.