a. Physical or mental impairment No (If yes, please list) --- Yes b. Interference with learning No (If yes, please list) --- Yes c. Substantially limits one or more major life activity (If yes, please list) Yes No --- --- Describe how the disability substantially limits one or more major life activities and describe the 4. reasonable accommodations that are necessary. If accommodations are no longer necessary, indicate reason. SEPTEMBER 2011
a. Physical or mental impairment --- Yes No (If yes, please list) b. Interference with learning --- Yes No (If yes, please list) c. Substantially limits one or more major life activity --- Yes --- No (If yes, please list) Describe how the disability substantially limits one or more major life activities and describe the 4. reasonable accommodations that are necessary. If accommodations are no longer necessary, indicate reason. SEPTEMBER 2011