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Apply for the Learning Assistance Program

Pronoun Choice
What Disabilities do you identify as having? (Mark all that apply)*
What learning related activities does this disability impact?
What accommodations or academic adjustments do you believe will provide you access at AHC?
Do you need help evacuating in case of emergency?*
Have you received disability support at another college?
Please check any organizations that you are currently working with.
Which of the following did you earn?
Please mark any high school programs you participated in to support your education.
What is your current educational goal?

The information contained in this application is as accurate as possible. This confidential information may be shared on my behalf with Allan Hancock LAP personnel who are directly involved with the program and have a legitimate need to
know. Allan Hancock College complies with the Family Educational Rights and Privacy Act (FERPA) for all student records. 

I have read and understand the privacy statement.

Documentation of Disability

Learning Disability: Most recent psycho-educational report signed by high school psychologist, college LD Specialist or other appropriately licensed professional

Speech Language Disability:
Most recent speech-language report signed by speech-language pathologist

Acquired Brain Injury:
  Medical information signed by neurologist or other physician

Attention Deficit Hyperactivity Disorder
: Most recent report signed by licensed psychologist, psychiatrist or other appropriately licensed health care provider; must include DSM IV diagnosis and description of impact on daily functioning

Autism Spectrum:
Most recent report signed by licensed professional;must include DSM IV diagnosis and description of impact on daily functioning

Deaf or Hard of Hearing: Most recent audiogram signed by licensed audiologist

Orthopedic/Mobility
: Recent comprehensive report signed by physician

Psychological:
Most recent report signed by licensed psychologist, psychiatrist or other appropriately licensed health care provider; must include DSM IV diagnosis and description of impact on daily functioning

Visually Impaired:
Most recent report signed by ophthalmologist or optometrist which includes diagnosis and information about visual acuity, field of vision, and whether or not the condition is progressive

Other Disabilities/Health conditions:
Recent comprehensive report signed by physician

 

Learning Assistance Program Student Responsibilities

 As a student receiving LAP services you have the following responsibilities:

  • Request services/accommodations in a timely manner.
  • Provide LAP with the documentation deemed necessary to verify your disability(ies).
  • Meet with an LAP specialist to complete an Academic Accommodation Plan (AAP)

An AAP is a plan to address your specific needs as a student with a disability.  The AAP specifies the adjustments and accommodations that are identified by you and an LAP specialist as necessary and reasonable to provide access

  • Demonstrate measurable progress as determined by the college policy on academic and progress performance. This policy is available in the college catalog.
  • Notify LAP in advance of any absences from class or appointment if you are receiving interpreting, transcribing, or other LAP services provided in class.
  • Return any equipment on loan from LAP at the end of each semester (if borrowed equipment is not returned, you will be held responsible for the replacement costs).
  • Utilize the LAP in a responsible manner and abide by LAP policies and procedures; and
  • Abide by the Guidelines for Student Conduct and Academic Honesty Policy (AHC Board Policy 5500).  Both policies are available for review in the college catalog.

Learning Assistance Program Student Rights

 As a qualified student with a disability, you have the right to receive necessary academic accommodations based upon your educational limitations in order to have access to activities, programs, and services.  The college faculty and staff shall not automatically reject an accommodation unless the identified accommodation has been determined to lower academic standards or fundamentally alter the course or program in question, pose a health or safety risk, or if a more effective or feasible accommodation exists. 

  • Your participation in Learning Assistance Program (LAP) shall be voluntary.
  • Receiving LAP support services and accommodations or LAP instruction shall not preclude you from participating in any other course, program or activity offered by the college.
  • All records maintained by LAP personnel pertaining to your disability shall be protected from disclosure and shall be subject to the Family Educational Rights and Privacy Act (FERPA) requirements for the handling of student records.  However, your consent to release information is not required as long as the disclosure is to other school officials (including instructors) within the college whom Allan Hancock College has determined to have legitimate educational interests.  
  • You shall not be excluded from the participation in, be denied benefits of, or be subjected to discrimination under any program or activity in a public entity.  In essence, you shall not be discriminated against on the basis of a disability.

If you wish to file a complaint or grievance regarding discrimination on the basis of a disability, you should follow the discrimination complaint procedure outlined in the college catalog.  You may also contact the US Department of Education Office for Civil Rights (OCR) at 1-800-421-3481 or 1-415-486-5570.

I have read the Student Rights and Responsibilities and understand this information.
Which AHC Campus are you attending?