Banacos Important Forms and Documents

Below you will find forms, documents and manuals that could be helpful as you navigate your academics at Westfield State University.

Banacos- TRiO Consent to Release Information to TRiO Support Services (doc) for students in both a Banacos program and TRiO to give permission to their advisors so they can coordinate support services.

Condition Verification Form (doc) should be given, along with the documentation guidelines, to an appropriate medical or mental health practitioner. This form is designed to substantiate the existence of a physical, medical or mental health condition, its duration, functional limitations, and recommendations for reasonable accommodations.

Consent to Release Information (doc) for students receiving services from a Banacos program to give permission for Banacos staff to share information and records with specified persons. This form must be filled out and submitted to a Banacos advisor to take effect. This form must be used to revoke that consent, as well.

Disabilities Notification Form (online) for new students to campus to disclose that they have a disability.  A Banacos advisor will reach out to you to tell you more about our services.

Disability Services Manual (pdf) for students to have a comprehensive understanding of the services offered by Disability Services and how to access these services. The guide includes tips for organizing work, talking with professors and studying among other useful tips.  

Disability Services Registration Form (fillable pdf) (large print)for students to register for services with Disability Services.

Documentation Guidelines (pdf) for students and practitioners to follow when writing documentation in support of students’ requests for reasonable accommodations.

Electronic Text Request (fillable pdf) (large print) for students to submit when requesting electronic texts. Please submit when you register for courses and at least four business weeks prior to the first day of class to have texts prepared in a timely manner.

Equipment Loan Agreement (fillable pdf) (large print)

Exam Instructions Form (doc) for faculty to submit exam instructions for the Banacos Exam Room (examroom@westfield.ma.edu) to keep on file.  Faculty may indicate among other things, any allowances or restrictions for students while taking the exam and how the exam should be returned to the faculty. 

Exam Time Reservation Form (online) for students approved to receive reasonable exam accommodations to reserve a time to take the exam at the Banacos Academic Center and tell us about the reasonable accommodations they choose to use for that exam.  This form must be submitted for every exam or quiz the student wishes to take at the Center.

Extended Time on Assignments Agreement (doc) (pdf) for students and instructors to use to help to determine and document a reasonable and individualized approach to providing extended time on assignments. 

Faculty Recording A Class and Reasonable Accommodations Regarding Recording a Class (photo, audio or video) (doc)

Guide to Creating Access: Accommodating and Teaching Students With Disabilities (pdf) for faculty and staff to have a comprehensive understanding of the rights, responsibilities and processed involved in accommodating students with disabilities in addition to suggestions for teaching techniques.

Learning Disabilities Program Manual (pdf) for students to have a comprehensive understanding of the services offered by the Learning Disabilities Program and how to access these services.  The guide includes tips for organizing work, talking with professors and studying among other useful tips. 

Note Taking Services Request Form (fillable pdf) (large print) for students to request note takers for specific classes.

Photographing or Recording Lectures Agreement (doc) for faculty and students to use when a class is to be recorded by the faculty or student.  The agreement must be maintained by both the faculty and student. If the student is approved for recording as a reasonble accommodation, the agreement must be sent to the student's Banacos advisor as well. 

Reasonable Accommodations Request for Disability Services (online form) (fillable pdf) (large print) for students to use to request reasonable accommodations. This must be submitted by the student to their Banacos advisor every semester.

Service and Support Animal Handler CDC Guidelines (pdf).  Handler guidelines during COVID-19 by the Center for Disease Control.

Support Animals in the Residence Halls, Handler Guidelines (doc).  Students approved to have an accommodation of a support animal must follow these guidelines.

Transcription Services Agreement (doc) for students to have an understanding of their responsibilities when using transcription services.

last updated 9/30/2022 LT