Page Intentionally Left Blank Sign below to indicate that you have received and reviewed a copy of Rights and “Student and keep a copy for your records. A copy of this document will be given to you Responsibilities” by your ADA Coordinator/ Personal counselor or can be found and downloaded from the Disability Services website at . Student’s Name (Please Print) __________________________________________________ Date ___________________ Signature Student’s __________________________________________________ Date ___________________ Parent/ Guardian Signature if student is under 18 __________________________________________________ Date ___________________
Page Intentionally Left Blank Sign below to indicate that you have received and reviewed a copy of “Student Rights and Responsibilities” and keep a copy for your records. A copy of this document will be given to you by your ADA Coordinator/ Personal counselor or can be found and downloaded from the Disability Services website at . Student’s Name (Please Print) __________________________________________________ Date ___________________ Student’s Signature __________________________________________________ Date ___________________ Parent/ Guardian Signature if student is under 18 __________________________________________________ Date ___________________