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Bucks County Community College
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Services + Resources

Forms

On this page you find useful forms for students. If you have any questions about the form you need please contact the Accessibility Office. 

For appointments at the Lower Bucks and Upper Bucks Campuses, a TAO staff member will be more than happy to schedule an appointment to meet with a student or faculty member. Students or faculty members will want to schedule an appointment to have a TAO representative meet them at a preferred time, in advance, by calling (215) 968-8182 or emailing accessibility@bucks.edu.

Verification Forms

  • ADD-ADHD Verification Form
  • ASD Verification Form
  • Deaf & Hard of Hearing Verification Form
  • Learning Disability Verification Form
  • Mobility & Upper Extremity Verification Form
  • Neurological Disorders Verification Form
  • Physical Health Disorders Verification Form
  • Psychological Disorders Verification Form
  • Vision Impairments Verification Form

Request Forms

  • Request for Academic Adjustments
  • Request-Agreement Alternative Text Format
  • Request-Agreement for C-Print & CART
  • Request-Agreement for Interpreter
  • Request - Agreement for Note Taker Scribe Services
  • Audio Recording Agreement
  • Equipment Loan Agreement

Appeal Forms

  • Process to Appeal for Denial of Academic Accommodations
  • Appeal for Denial of Academic Accommodations

If you use screen reader software and have trouble viewing any of the forms on this website, please email accessibility@bucks.edu for compatible formats.


How Request Academic Accommodations

How to Request for Academic Accommodations

  1. Go to Bucks County Community College Website within Internet ExplorerImage showing that the Bucks email login is in the far right side within the Bucks for Students tab
  2. Log into your BUCKS EMAIL account under the Bucks for STUDENTS tab on the top left of the web page  ( This will give you the ability to electronically sign the document )
  3. Open up a new tab and go to Bucks County Community College WebsiteImage showing Internet Explorer user opening a new tab. ‌
  4. Search for Accessibility or click the ACCESSIBILITY RESOURCES icon under Bucks for STUDENTS in the top left-hand corner of the web pageImage. Bucks County Community College website. Search box with accessibility typed out.
  5. Go to Page: ACCESSIBILITY OFFICE | SERVICES+RESOURCES

  6. Find the FORMS section on the right side of the page and proceed to that resource‌‌‌‌‌

    This is a picture of the forms tab on the far right side of the accessibility office page.
  7. ‌Search for the form that pertains to your accommodation request‌‌‌Image Forms Section. On this page, you find useful forms for students.‌‌
  8. Click on the form that pertains to your accommodations and it will open in a PDF format. * If your personal computer does not have Adobe Reader installed you can download it for FREE at this link: Adobe Acrobat Reader DC *
  9. Enter your information as requestedThis is a picture of the form as a example for request forms
  10. Sign the PDF digitally by clicking the sign box and following the promptsImage of signing proportion on the PDF Form showing where to sign.
  11. Selected new IDImage. Sign Document. Sign As: New ID...
  12. Click on 'A new digital ID I want to create now' option and then click Next>Image. A new digital ID I want to create new highlighted within the Add Digital ID window.
  13. Make sure the 'New PKCS #12 digital ID file' option is selected and then click Next>Image of Add digital ID window. This shows the PKCS#12 option being selected.
  14. Fill out Your Full Name, Organizational Unit as Student, Organization Name as BCCC, and Your Bucks Email Address and then click Next> *Make Sure you use your bucks email account*Image. Enter your identity to be used when generating the self-signed certificate.
  15. Enter a password that only you will know. Be sure to write it down, as you will need to refer to it in the future semesters. This will allow you to sign the documents digitally and provides security on your signature.Add Digital ID window. Enter a file location and password for your new digital ID file.
  16. Click FinishImage. Confirm Password, cancel, back, and finish button
  17. Enter in the certificate password you created above when prompted and the date within the window next to your signatureImage. Your Name, Date and Adobe Acrobat version. Password window highlighted.
  18. Click the save icon on the top left-hand corner of the screenImage. The save icon in the top left-hand corner of the Adobe document.
  19. Select your desktop in the right-hand corner under the Quick Acess bar and click Save in the lower right bottom of the windowImage. Desktop quick Access is selected then the Save button in the bottom right-hand corner.
  20. Email this form to accessibility@bucks.edu from your Bucks email account

*Make sure you attach the form to the email before sending it out.*

A TAO staff member will be more than happy to schedule an appointment to meet with a student or faculty member at either Newtown, Perkasie, or Bristol campuses. To schedule an appointment for a mutually convenient day and time, please call (215) 968-8182 or email accessibility@bucks.edu

Steps for attaching the completed form to the email
-Open 'create a new email'
-Enter accessibility@bucks.edu
-Fill out the subject of the email and add any details within the body of the message
-Click on the paper clip icon
-Select Computer
-Select signed document on the desktop
-Click Open and it will attach it to the email
-Click Send

Image. Open Window showing the paper clip Icon in the middle and the computer tab being selected.

How to Request for Academic Accommodations

Home 2017Services + ResourcesCampus ResourcesAccessibility OfficeForms

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The Accessibility Office (TAO)

215-968-8182
accessibility@bucks.edu

Newtown
Rollins Center, Student Services Office

Fax: 215-968-8383

The Accessibility Office (TAO)

215-968-8182
accessibility@bucks.edu

Newtown
Rollins Center, Student Services Office

Fax: 215-968-8383

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