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

OAI Accommodation Request

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

Accommodations must be requested for every class, every semester.

Please enter your NPC Student ID Number.
Your Phone Number
Enter the best number to reach you during regular business hours.
Semester
Primary Campus/Center
Previous accommodations
Have you previously had accommodations from NPC's OAI Office? Select one.
Please note: Accommodations are awarded based on the limitations stated in your disability documentation. You may not receive every accommodation requested. This form serves the purpose of beginning the conversation and is not intended to be viewed as an approval or authorization of an accommodation. Follow the example in Course 1 (you can enter your own data here, as well). Enter the Course Department abbreviation and Course Number and describe what accommodations you are requesting to help you succeed in each course.
course1 accommodations table
More time on tests
textbook in audio format
test in audio format
Equipment Loan (digital recorder or LiveScribe smartpen)
Ergonomic chair
Sign Language interpreting
Other (Explain below)
Please list what accommodations you believe would help you in this course.
course2 accommodations table
More time on tests
textbook in audio format
test in audio format
Equipment Loan (digital recorder or LiveScribe smartpen)
Ergonomic chair
Sign Language interpreting
Other (Explain below)
Please list what accommodations you believe would help you in this course.
course3 accommodations table
More time on tests
textbook in audio format
test in audio format
Equipment Loan (digital recorder or LiveScribe smartpen)
Ergonomic chair
Sign Language interpreting
Other (Explain below)
Please list what accommodations you believe would help you in this course.
course4 accommodations table
More time on tests
textbook in audio format
test in audio format
Equipment Loan (digital recorder or LiveScribe smartpen)
Ergonomic chair
Sign Language interpreting
Other (Explain below)
Please list what accommodations you believe would help you in this course.
course5 accommodations table
More time on tests
textbook in audio format
test in audio format
Equipment Loan (digital recorder or LiveScribe smartpen)
Ergonomic chair
Sign Language interpreting
Other (Explain below)
Please list what accommodations you believe would help you in this course.
course6 accommodations table
More time on tests
textbook in audio format
test in audio format
Equipment Loan (digital recorder or LiveScribe smartpen)
Ergonomic chair
Sign Language interpreting
Other (Explain below)
Please list what accommodations you believe would help you in this course.

By submitting this form, I certify that the information I provided is accurate. I have not given false or misleading information. I understand that if it is found to be otherwise, it is sufficient cause for rejection or dismissal.

Sign above using your mouse, or finger on touchscreen.