ࡱ> 9 bjbj.. 8&LhLh 8(4\m#^xxNNN"""""""$%(Z#1,"N11#'#CCC1R8"C1"CC &!y[ "=#0m# ,)<)&!")H!N"pCNNN##MNNNm#1111)NNNNNNNNNX R: Student Name: ______________________ Date: _____________ ID: ______________________ Address:________________________________________________________________________________________________________________________________________________________________ Primary Phone: ________________________ Additional phone: ___________________________ 91 Empire Email:__________________________________________________________________ Please check one: ___ Undergraduate Programs ___Graduate Studies ___School of Nursing & Allied Health ___Harry Van Arsdale Jr. School of Labor Studies ___International Education Area of Study: ______________________________ Primary Mentor: ______________________ Please check areas that apply: ___ Veteran ___ ACCES-VR (formerly VESID) ___ NYS Commission for the Blind All 91 colleges and universities are required to offer students with disabilities the opportunity to register to vote. If you are not registered to vote where you live now, would you like to apply to register here today? __ Yes __ No, because I choose not to register __ I am already registered at my current address Please describe your disability: __________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ When were you diagnosed with this disability? _____________________________________________ Who diagnosed this disability? __________________________________________________________ If it is requested, can you provide current documentation of this disability?*______________________ What accommodations are you requesting? *The following accommodations require documentation. If requesting, please indicate below: Alternative Textbooks ADA Part-Time TAP       Disability Request for Accommodations Form Submit Your Completed Form To: Rev. 3/21/2023 Email:  HYPERLINK "mailto:Disability.Services@sunyempire.edu" Disability.Services@sunyempire.edu; Fax: 518-584-3098 Telephone: 1-800-847-3000 extension 2244 Mail to: Office of Accessibility Resources and Services, 91 113 West Avenue, Saratoga Springs, New York 12866 For office use only: ____ Approved ___ Denied ____ More information requested ____ Documentation recd DX codes:_______________________ AC codes: __________________________________ NVRA code: _____ Decision by: ___________________________________ Entered: Banner: ___ Email sent (student, instructors, primary mentor): _____________ Date: ________________ Staff initials: _________________ 89>TU] U V a b h   / 0 4 7 8 P ` c z { |  劆h2hAh>qhACJaJhoZhSjlCJaJhSjl h9uGh9uG h9uGh,u] h9uGhoZ h9uGh3* h9uGhSjlhrgh>qh_@CJaJh>qh^CJaJh(0h_@h^hZLh9uG hZLhShS3UU V { | > ?  P :;gd>qgd9uGgdZL ! = > ?   P  :;'FKLMϻ~sh>qh CJaJ h^\h3oh>q>*\h3oh>q\h3oh>qCJaJhh>q5\hC#_h>q>*CJaJ hSjl>* h>q>*h*rh>qCJaJhOWh>qh_@h>qhCJaJh!iF h!iFh!iFh>qh_@CJaJhrgh)LM$a$gd!iF$a$gd^gdgd gd>q !?ö|xlcZcch5CJaJhF5CJaJhZLh![.5CJaJh![.h!iF5CJaJmH sH h![.5CJaJmH sH hh5CJaJmH sH hCJOJQJaJmH sH jh+1RB* UphI}h3ehhH%jhH%Uh h 5CJ\h>q5CJ\$jh^5CJU\mHnHu! !aWIgdgd!iFgd $a$gd gd~o$a$gdbP#$&)78ACQ`ais·ʪ֞zrjbh1CJaJhB9CJaJh7CJaJh CJaJha+mha+m5CJaJha+mCJaJh7QCJaJh7Qh7Q5CJaJh WthS0JCJaJhShSCJaJhSCJaJjhSCJUaJhZLh![.CJaJhZLh![.5CJaJhB95CJaJh5CJaJ%  "@BCVW(IļļĴĜvh hCJaJhMxCJaJhhCJaJhoZCJaJh![.CJaJh1CJaJhCJaJhACJaJhVjqCJaJh h![.CJaJh h![.5CJ\aJhH%h3ehh![.hZLh![.CJaJheCJaJ.h hH%6&P1h:p(0/ =!8"8#$%@ )Ddd  C @A(New logo horizontalRqeV/MDTFEeV/JFIF,,C     C   " }!1AQa"q2#BR$3br %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz w!1AQaq"2B #3Rbr $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz ?S(xC|E;[uoy?hۂh6+iAqu 8뺾k2,)q}Z`r|na{ދK2[Jj2s\fz}Qo%yj%Ü/A ʯ̱!֕ぢ-_ܭoqjU(GߴK4WqKB\@"KKȀ1jZ+)M_dɯޮ猞W˛z|cP''}Ӷ3YTWSJ~o=hap iz$^#wjh|S[c/\׃YtV+Z.of7w͏)Bt:wΞ-6כ^2 5o;}ױS-V%=Iʺy-&Xh'lQVwb 8N9Ud/5ߍ¹uo8?'w>㷸 Rhe^6 EK_$<;7_Y>r|!Ot?Qٔ\PrJmr>bm \'޵>gc8OFM}Z+-(ٷ&OQ=~#޺Z#К_TF ubGQEbQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEbO~ժ]]Ϣ׃y*fxs}z/Ͻy爵kkZaF'z+24*8W|O_{?ek J~~{/Ei.$y%vG9gsO4+ý OsoH2kha*t '+j֥=Y(wUK0U8u5g P^mDZo _ fmhcHscq)K%IOZ~'EЋt>)6û#$D+P45FʵXߴʶ_J1'3ܮ>׮/'X֤?rgݢ|'p&;N#2?+<4~%K_o/Kٞ́.9|7øټpc-Tq'gtWoMkW x!xNCKjIFQaL r|M'Xo,iBzz?xdWNU z=k Go,Gt+bʞ QlgV/C Gٞ+?wk6I/Qkr#ҵk+ -.9Y#l<r[QÖt{l}WUO9^3(傊+|\ixC~vYeϹ+c+%|/@|{?_?G>??+>\ʶ?讳G̳_|#j"nEm!w6U%?Uwiπ|s=ֳ})' "KkiC:v韐WQ_0_!1GhV:g cy2I ܠ_$~1 xxi%I3ܚ+ট i>'\E;VJ `sU EI+>)jzZ@Н;+?LWzl}p׽} q/ ğQ??+_5JaB-pײϰFպ#?^;SЬ;ܢ/f>8"Z„a4ZܠZ+8Ѭo#Y?Kij՟ڶ?J+Қߵ¶|<D/$^]2YtzLOTqm(/IY%!#|D+L 8w9k((ߵ'e?%ua0-d?]pr>K?r?_+>~\~?o|ǿ =ϟW/+%|}2{ڳۄu+ޢmϏ~\~?o|ǿ =ϟW/+%|/@|{?_?_v5k~Z'.m%ŜVV"U*( (>;|WhΡkoiȚ_paj +LV~%ӯ"kVc `Y ,y\Fk῏^9|#[ٛHrT@%Q@|W5:xL22#5>~\~?o|ǿ =ϟW/+%|/@|{?_?G>??+ſRdzn;ä.qb+k>gjK%|ѳ/ɴ?ள?>??+>\ʿEᏂߋU۬_} EUUBQ>eLSQ_{1?t (3((Wk_7z1¿,`DžQOU…9U#JtVjW|Nc\յ+RV"1bp;yZmVk)@Q(%ȁA59Yq9Tv׿Ec^ae[[p+z?OТ+0*?gҿ '7kh+o5 ??& ɟ/zn}4W8gZG8gZ@tW8gZG8gZ@,Kzs|'|3៵}LӾ~wǿnN2qdC@ŏ*~2z?:-n<3~V oEB@NɒQʞז|X/ V?/=oG+E:"{{UUzWM__OۊU64 uj.l%< QVx4]jĚ=^Ci%ͭݳhC# Az( (]𿅮af\T T`X.߷+>ݳ+Ů֯󾱶C&<9E<|vuj7^q;Yy$I'j~?|ScSMg?9 }@_[O ^,_[O ^,@W'#&ⵞQZl3DټҀ?6O?F>´#"́cXzʊ8YTr1/T8gOxz5;iMrUuaaІ O?Je`[/?ikQvA»Qe>},+oCEPIgĿ _UCY/6 U|~ɛ|X3i_νEŏ?Eź>%motlI9?_^(xşß4V,:%dIf#?~foE@OKQw`u1ʼ; Ƞ)'oT4˩xFJ/$.Hs@x(_~9~!. ƻᙛ@*ĈH{axcՑ}a@_[O ^,_[O ^,@WO#_- -H[=__gD /knn3tj+ScU-OcU-Oʺ~!,aklSk؇55toK/ڽ6mI=sh(+g u_5I>xQk?^[[wĶPHKxdHfaʣ.9|γ[:=x-,fQ}+g/I bFR/濜G-z*(f,I'$IGyqOx|/=.'<1YEyXph˨QQN[\ZFg<;WY:̖Kϊ1pg;3ր?,+ox\cHL0gtȖGנ|r4ϰ{o]p䶷mDuR+|o+_Ң&̹hV?-~gt}#Nɴ`<Q~0j-be_WM|Uk7᰾*i^2tXb}~?vYE~ÌݴÌݴWEvžhk?ϧ}|-68q\UW߳5ɼ /"^6}>ƻ<6>fsNkqV??*s" lSkOw&1]g &[M/>G cΗv|lch ( k~|UiW[ 'd&@UHLQfy2mlyGȃj]K^*'{$WEzoy?&v ݼgIF͌mKtUZ.awQiwvPHH#Wh_ ?YJe?O<o ?ZeΝ/|=r7cvqu1v]1v׊~ןLeOw>= G{37yi:mր>(E>!y|lboY G>e}wtWÌݴW_E~UÌݵ@\o[~qVG_o_QE~xO Gtmg/ٿlgҀ?0hOqV?qV??*&ƼcU-O?bGfJ-v.ly{<3#;qڇ\Ff~Btokwؿ!__WO(((3'; G)Wt6pH鹏e{wΞ+HnĤ@z>094򮞯8/iCgZŲHcɯ,|Ro]mhlőd~v sǟXMtxE["տ嫡H ?Z3ψ tiZ/Sm7I`r,Q/՝/՞2'?ZxiV{n$O0z>:uM =ui]o:SkRwj$-pz͍t"41'ŏ]Ƒ\-ơ 1s@:vt^}W LxS|a~w5z(su?FϗOV1 Q_QEs_@yK"?_Ǖ/?v/+^G??B(O¿}J*?gҀ>U?{_ I'f_p<'KZCI9-.dʜc~z,_mO$zSP?=O1_heoZx~o 69&4 |Θ@EPcJ3y޹Z,So?{+@~3o/Z/&ƛ\?=ßv:0 =(l GfG:͟:@9@",GRB ywouoQVuYv<=Tp0O5Ox2Dp/܂%?u~$cbOEPOSMg?9 }_?|Sc__'__W=ibΙ/_G$:g@_Y?zG~ -b~T+\YLB1%(W<'_d>'<n'աr7}I@QE~+|K/bE3$./7պ~ "¾$__5(4_أ3ʮR T8E=O?Je`[QECY/6 U~j|KͿ5U@?ߟf? W_G&mc:WLNY_Ho3m;Wڵ'M'WG#&=1ȧ uVeM{=|_l侍|U{"Xʆ9'ۜcvTQE9פ+Dvs.%c@+N3~O{7#5MNLMRHw}~WHfK=~6WHfK=~6P_ҟ&oHa沿O>c4? ~jxwD5N`".;Cl2qE~`O$zSQ?=O1@WL>/k96;((>5/}Vc5jZ'qyb@6^س{m ( (s/4]}#E2Qcw$ k<9oIo..8F[BRs]oůZ?&oe@Ŗ Ĥj/( CwT2k RyM>RLX=8=G_|~/6LyZğٚ6S9_, ;Y4k$l+) 袊++a Z &mjCj,((;?7+L?Cz (?0?+|#K@jiȭu/޿%7D%0U-F 3|)m: C2hqnǑqV0?'=C(hH+ 7~?Zx2XmInm 5E|=tokwؿ!XZ\Ff~B8hT (?B꺔:>w}pqM38rgԼAnm˅QBW2aU(ŴӍZЧ7dOϖ5]KQ%u{pF 9<*(}+t߄V%q3ߗs;p> V~mM2g+ąy|Q}f}FBH~Xc^ʣzrpf:ZeKci:eS[n٠}xkV(\M7?PT7-W9bfSȻEF)}Y_>z}i?>%4m3a(kFub[&K}rR\+}+C2/dPGMsݮ5Y4_h CsWdd*}(PWoIݶiap%UKkd}ͷp)A<+|`m#vi^Sf{"ƪUFҿҞk*aTv}O9!UWk>(9_ xM|y_aJ/kOYUE|/_tW۟yƟoEW'a_?T>ω ]~WOo?i@*Ev>%~ڦ[58C$臱2<IߏK(j6ɣymsoǿ %K|U0$դn/iyoJ3*zPTQE0??7=땮?fGrQ_r0~_g<Oڊ*K{ynX敺$jY*:YaT7/<ӶSt>>&)۶(&ƾ?>)//+OO;~,l.<6&C$P"6fSq_PW-ƅ |+?x"X. F<y?OUkD=uu|YW/臠 ("ωJW$_mAҪ6`gҿz?o3o +נि?fpxnYK'!1">ZBkW dž(1hQgO\#-$pIIUM E6"64 rH1u$ _f|UyW }.&4P3G{Fu#_XNee%gE;WE~um?xae~m?xaeQ_fx ?7|;*«mh xT$#'O9x??Ϳ4PWO'M5_GBYŷGNeo]( J1ǭ~EPEP_=~^|7Uԑ^*7Ϣk[7yE&L/ \hK?64Y}Rlt7QXd"uA|’w^ɏ\Knc|2 4mҐ{83_s|֗AdH/S9^_@tWK+WIxúX6B?ee>P?[mV|'nƩ#IhOb=`~p`1_qoW5{PS.~bu }T8 ov y$yJTp0{0@ i_ 5}iZ]ĬAhxĎMuQEwf^+^k|^G5x}mfF~ /?YѶ@Q@~gg?hor˫k*gV_ƿHr)gi]\Ij]~_w9` ؀kTC+ľ W-MBȿᇳ + wC?Nj7F5F20/$sk)ٓh\}_?gFQ?^ڃ <g9ZDqIw',v'mW:p(OP5NO|5|w?n.s+(,(aAIr/kT_lzFs&[iܝ k]{s-sK`Ur߉ǵqxw^<דM   s8VӞv劌SK X&zפ&j[O '_A/+e2H?o# jگew 3r1p+%ȁA5}+Dה +_?hgW_W}^n?Q_~Q>&3Mv_?T>ω ]|_J7O_5׼¾7о_7о$xZĞt+g$**Hϣ)ncJ3y޹Z,So?{+@?D?* o}hȚo]"WCycr91Is!T`[k?ox]c[&Ӧu.soui:ᑇ U V0 +tࣟ-w-#foog?&6=S_oik+3>٭,+oCEPIgĿ _UCY/6 U|~ɛ|X3i_νEŏ?_mLOCo_xv)' cN@ݼJs_WLNf=hL8VLt5I{|([}Zo$2 X*x%τR;;#~矼HRyq__ 4/idjv(p/,܁,^ ꧵IV?YºG+ U?$NC<ؠί-/?zl?-/?zl?;Mg7_e~  M_nai-&4v$/Ue (Z+oLJ4~~?V- wViW,6pJ9s0]NK `~=QEefuֹ-E˳;-a(f?U|gރ-4q#G8pʿڀ (?[N9kڿmo;3_w,z#o76޿o+;ygTU I@`?hoWiw;5~->&V8y9J+Z''ExLh/~6 kh?w_GU׈|/k~)'1w(m#\`C3l~M'YB/?_=_߷ O姎j łZj9T>YT9;ʹPJTIEC7 ?hٯÚzbdk 70k{Ȇ9>õ}_I/)u;pdǨ!&dL*ɛj?ھկ?fڏ?6(?L?Cz;?7(( "?Կ z֟.7R-Z ~+olBW_/۳7{m*y( S@Q_?~~?VvEf¿x[1jEclrC櫼ˑ&?SY 6,—ɭ;`h]0>QNz 9׳Dž0UXi􎾗7,IrGgruwCM'pkټ񧆭gk1`#g7Gq#˳zm+٦ɱu5Wݷ[Q_Lx5+Dה +?_ xM|y_C??Xj诅|7so8a(+ '7k |=Vn|H|5jRfw6M A}A?M (O|Ah?M (O|Ah?M (O|Anɒ-++]2-'IosG"w1R־?fGr_wxLC3AȮ_?M ("O_c?#Khz=֒B&Y(?KgSY++o-A<Ԓ8Rmd9$Q]W*ЛQ &sTYOw_Cc_FjOk闚UEr8#>ƾί-/?zl_,džo| L>{V63*a Ͻ~B§ \Er4~_@~س,u§ \EH? x'zjIU` ڀ;( ( >,+oCW\8dcFGQKhT77+?M (S$_mAҪ/gXkM$ŻF p!# 0/@?ߟf? W_ч٧߲;;i.cw@?J~S"9ZCɛiֿS"mO42k`냵84E~^d?e +N۠fGxb_ ;m[XX0 -Gխ%~E"au֗qz][](NOue i$ 3%+ 1[@ʿed$s_oBo?W?@§ \EoBo?W?@§ \EoBo?W?@~|K-5*ЛW~'|FX-&)t{u$9,M~EQE忴~|侽,`&܈gpY@ej7Zƣu{SzʰǢؤ<IߏK+qiyCx"֣.ѕ) :0oxᗈ?X^ Z|v2,2!';E|Uy65a}_Xt=GgZ,XAg K!'jp(~S"T77+L?Czewp[FRD;ۂd{QE~`qVG_o_ )]H՚Dȶ61@RT77+VS"T77+VS"T77+VS"T77+C?3[ ~ [1,,p>_1)XJ-Q_W{]{{- nC\iŌ[WP'ZM_R/Ɗ(((((K-gX{]KE-!bN:־>\ ǔL 5u~rbk}|~aU%FM_@+Sc"?_ǕĢ|A)?_"8;گ@+ ɯbOТ+0((((((((((((((((((((((((((((((S x+:Ɨ?x~U@;q&;te;[B1Mc|%BݺN j;? h(((((((((((((((((((yMjц]W;"44kN%eCҐG+h ]Z]?ut "<3GkJ+GS{?U>uh5&Pm\IJGOU?J|5}&bNZ?ǨϨ|L5`aŴi-yf 帩Pۧt@o56X8%EEz1ѝ $uHՎiƗ^%6&7}``e֗ybm'st2r+ꧪivՄW%ͬ˵q+JRn!ߥgS*^֊>#|?𿉯t{[TmL3G rGC `` |#VTjAEb֧W4UOO°ej{{;$~ *炵={^͝)q*аd΋xLvܞ}plst얟7|qSc^{/E?[toC34 =K袿lss|̳|m(9EF($lʈf89 5l\j,(;s?Uvq NJ$?ju/<0+*cfsIc_oc\,M{|kGKmgMQ]'k_Pη*~<+}?ЯN5Gt|ldh-}^(φ ?goO|7x>EyK;.ͳvrpҰQO'}Jt?i#GmO"vvie@F=+%S_my+kL~?]tkXr), q-~^?u/X @e=_k/ׄ|]_Nl?6%SR q ۶gz޻{&jqm`T27*3W/SN?&]u~E]gm@n^6nt5[k𭵼26g Bpp=^TQG4߄?5e 윃K9QO+z(?,kO*oߴGx>qհ´DZCѧ7m_?2Ҽ?;O+o<٤<1ճ1!_I}1pOJpCGi~qiMޗ)`ggW}0??7=MT| ,t?TX:42q08Ivd9(][H|'/1K%՝̲[݁0)]d@F4{?M}!U|"}ɧJ&?@7Vaހ?/-g4xO2h?Nn`>@8=+3B|Mƙs[GwksKPtB -o-ehge*ȤVG~"~> n|s-9gs[c豧}Ehg/ž5ރS6\oϙ{/pwjc?ǟ7MWAЦ2^3K% NjSP^3~ן5M3\'D*(^;W~} G?/x[ǐ|KЯld%FcA(|dOx3gt?ot3Ms"Ap+idS^/'Fa:0!D Okk:o9?]5{'1j]tk 5nL~U:ckx_ AGe߈PҼLg,G!V/čOڌFs}Mg$I`p+Ǿ"u?G5B4%tcM6k)8YI0OV7msϋ5_ LG״ 8H A4D[EyoJ*X2AAZ6~{xjRLĴvb'I(閥[u܋ M<7DE<#h0k^)ɧxnudAE7IڭO+ǟ_J|eQitwR=1 `Ysľ:%vծHfܶ_Q3Ԛ'+m.Եwv6ht8)7(.OppSi]&K/Xh% ''X`Ҿ?";{sT9zf!~%_v !.}4./^.eEȆ2sG|/$ox@Ҡl״y3]´YBf;w/ˍ"?hCѾ,xD񇇤]X[I.`x$d= GC5忶ǍlfM,.-" Z)$"Y6ܱ6paϭ{/|;aiZz]V6/H"|`%~W|-B_e~wϩh}V[x`PN=喿/ ȫה?-hS /'xÖ>,:>y%ŅH;ƥȻ 3{ VL<}eѼwOwoW:["3J v3xx_z޲NB"(slsqb<Wo.?VL+keN_ AyͮA$a,[f<2fzB_e~|q7ÿAu蚷}bJԭf)1aXFPY $U}|3}#E48lĬ Mv:{_> ]}ɕA VߵV4ٍC/&9# ńr&8!'nkg Q)6rPm<.\=@qrT`ڂkƛJz;^rن&uh8cvhoxI=_ĺz~yws!8K188 l໵;YYb& 2 *pw/3f+p[?OVz@'|n$6Qwr\,%dUgیP ?ڻGqgD}-:M). ! -ăE /,a__ ,xw7ȍa|cH? >~~.%`nlr6:gcݘQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQE [U :adJ8X}?|{Zu^][G_QuiںtYSEo^G~k|?,uzޫu]`j=gO}_Tr<2,# Ѓ_M!N&nQCQ>ce*8 wq]Z\B3wCW>(_3|+rKg}Ey¿0=;St֔`.=ѽWks/0ٞ8,gl WFl漂O3i.Dj 3p|BEvVnDlsNrFgWGR R>=B"KDyô?<+<Uy߳ݶM>;.6?¿(u񱹳-/oDyô?<+<UyIa Ɲ_Hk;x:c&[/+z_* Kot>%;]H*ʾ||d[(? m񐕷$$I{zW9baӻ-Ӯz&kau=,{zQ_),/{qLп/Z4Cf |s!U?=>|8Ê,+{~Ù q :ΥmciqOk_ lCTOF#?ɏAǭ~msb +ifT;-d].w A PaKddoϧVWU 4FbKU:ӕJ+c *?gҿ '7k!T`[k ?U>%G y:?J+_:"7LgyMڿ?t)2KkOş*?7j[hA)O }6{huX Et<,OF R=_ "MgTKmt^IZܹ.$?{np[*.[Ky)BFpy  he&$[-n\@·8,Ok~$kg??|R$l'0??7=~?fG~?f6U|+mGDTcc Z}x6ԐH[ԱIOƼ A˟#a껎b$<7' ??|A?Kڹwh؇s# u`Q_YxvLݧb1'ԏX Mv?f?J*IyxGM\R-ݺA ,?ڛ[43Ͳ|zgx"V?c*4ek]2k@6CL-V,_X?|__w_`WV2_qPR^WF(Z_ԗUѿ\ş%~2-z$_@BM2_qs_ПwLoy\\Q@/^~ZwE?[eו=죋[bpHV#c_·=xK_ԴMbM?VӮ$a_Խ~KaeR,izx8`>1nrh/ Y|)O x6'-bN d0g#<_*Fo /duRK˹ZY]3'˯?~-mOxwf,ws+)(+ 7'£V _tW|Z,5vZ" z~y`Mu\ :(q?H!TpǧI~gȲF̎2GB{0K4$b[ނOC|&H9 VV Ze~[K/g]y[{:^E 2á\4)*8W1j^ gtP3!2ӭ}~-t1te8Hb9I8-#=_r>0j6gǒ7>q'KWw׿%EF9^]#z~[FUK3QO{oc0k>"4~ Bz4~da֝_DE2> #!1s#?JJ(̣)eïWվ?0+fUjtKQE`QEWWBk?ۓ %Zl{BFZ|~*3iֿؚя;ٞwGu$jh<]h}#@2'_UͿ5ٯ>.!&yl<~ >^Լ3>+4.p͎Ufܻ45;g-OKĐ@N ?ck;>~>AŪl7ݤ.>_8D ܳv('!+~ᴥ'4޴ٟܰڿ=$(?n~,Xɗɖ]M:7V`ꆿ<_NX0[~iS6@WXP91x_jޡqRqwu!y\GƛHDQ1pOyl$xbG"d`pA~ oRTea?WcJ3yހ?e?h3^z6ɣym+:^'Э -o 1Y-AEk>htɬ,Sncw;/"=+uKlIxNY)Ws3 9\~w@IK-/M1 h{P? Ѣ &mjCj,?+a ?`??T?I?~OTX?~dEŸh> m<9rlԄ2P,Þ>ѿ;e4"#9+kV;ճ|֗ɒd'9><-~De܍*?<8$4VQ*i8dᑣY$RU#"?UP0 Z ]/߈/V_xR4֘ ׹c~`͠7~ i㧗w\d{_G~t.>ߛ=/Ě9fڀ#$DHú k쏇ߵ'/]x_7u1([rp7!Y>?h$hZ=7Ms!rp7($k'|V!]6XH>J3H#Os@_KOٞ z|A[n.fm\BzdLDX?|__w^cV5{eaQYT5V2_qPR^WF(Z_ԗUѿ\ş%~2-z$_@BM2_qs_ПwLoy\\Q@r<+Ꮚn;+P. )DG GJ+'ş*?7j[k[ 7G4}F8/mN{ۅ<4HX$j5S_I2_rQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEyĿ^6l 6;8ٺksA%l1WG=Ǹ+ Ҽm]NyN$_/Zg>&* P{VC:^RZ\/!ᇣ{V,3/tKȗ =눯1|^WuSR?'|}zmN&hk̾!.)8o2Eawc(:%Vnw~cN*VH(̲ƟxtkEeup}%^@jMq'D^UdQ[ƽXtT+wkkk:PsU\}®i=EeIuu!Ak_Ǔ>˧+bKTGa_Jx7W~ϧC͹$>q_ip+8j_r~+csn NNor =b5-23cQEC26YAa|DZxꮵy]Q^QEQE|V[ߍ?xu V<|CdBA2b[E~N{}^68bkUHSDGv6NmUx\qxg]lopBO@}׷$(;rM}./<'^ c(Һj:K HN K[[Kt1"DP:C-}`lZP@mC_+ i=7 dG*aN쌃kZ(( 57ᖞ%3j4 u#}=[gq xgT9#==BvziAjn%icT$nY=-W+[ԟ<`ˤ_xC g _UMo"_IodQ[_qEC^|Q:6lfm%ռ+,R)GCT(5n5&>_3٤'d6'S+¿ EP4;EhS3%aw5Ixenkn%2 tc5n (>0 2l؟..݅~'PW =oڇQ@mC_+??~HM"MffpQ䓊h?ڳ:CX# C{1r+^i $-͹U6BGyCEXV_. HK -GaB^m~@3wZ2l<@/Bz0VꢿY4#mľ/m?ź4kf>Y##Ш -xHIZ->XdX9Q8R8 ƿZ-w0x{~Ю!U.ۺcWg@?~ Řд{e98,ً37vb{͟UK;سŰA%y(Y.+(lO[6?xQJ_G`8r`VW+YO1UR5 $![? +@_N{YbC$-hR? }#EQE-}`lZP@mC_+g WgqaxJ$o5c ܝ}uEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEQEG$i4mF 2=A>2em.9fs'ۧҽ,RX_ 0=V?T|G7wZ\~h\U:;|_cmR.}:IV^ ㏀˭`2|AWrĽW_U#lSOgGYE9e) >>˹Chyto\`r^eWiK{/fO&?Nu֭yW2$Q)f?q}b%.|~sҽ?žkvē,7{V~ߑ>jO~zyS[zX?r=/̊aHa!0#BTQ_$>ՅQLAEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEPEP7qx ZyK ;J(>2 Title$a$5\4@4 Header  !4 @4 Footer  !6U`!6  Hyperlink >*B*phH2H  Balloon TextCJOJQJ^JaJN/AN Balloon Text CharCJOJQJ^JaJRvQR S0Unresolved MentionB*ph`^\q PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vj\{cp/IDg6wZ0s=Dĵw %;r,qlEآyDQ"Q,=c8B,!gxMD&铁M./SAe^QשF½|SˌDإbj|E7C<bʼNpr8fnߧFrI.{1fVԅ$21(t}kJV1/ ÚQL×07#]fVIhcMZ6/Hߏ bW`Gv Ts'BCt!LQ#JxݴyJ] C:= ċ(tRQ;^e1/-/A_Y)^6(p[_&N}njzb\->;nVb*.7p]M|MMM# ud9c47=iV7̪~㦓ødfÕ 5j z'^9J{rJЃ3Ax| FU9…i3Q/B)LʾRPx)04N O'> agYeHj*kblC=hPW!alfpX OAXl:XVZbr Zy4Sw3?WӊhPxzSq]y   3& >@    B X@ @ (  b  3 #" `? B S  ?H0(   F'Gtyjyj  9*urn:schemas-microsoft-com:office:smarttagsplace8*urn:schemas-microsoft-com:office:smarttagsCity  bi*5 Z a 33333TUUVbhhz!=     TUUVbhhz!=!$ & ` t    " @ B C  qwrnh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJQJo(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJQJo(hH qw          @ @ @^]\$=%>` | oZnh$5Do2AH%'3*7+![.,e2;24S7A<93?wE!iFvF9uG9INQO7Q+1R>TRISOW,u]?cSjla+m~oA.p>qVjqtMxQ]yG3e/ZLbP% ,Z;G(0I8=_@^)rg1SF S&fMYM e2 hj$<j DKBm:(.7?7)+B9@ 0@Unknown G.[x Times New Roman5Symbol3. .[x Arial7. [ @Verdana5. .[`)TahomaC.,.{$ Calibri Light7..{$ Calibri?= .Cx Courier New;WingdingsA$BCambria Math"hFGFGk+/+/!820 3Q@P ? 2! xx7_ OEmpire State College Disability Delcaration and Request for Accommodations Form.Disability Declaration, Accommodations RequestKHERMANNMelissa Zgliczynski Oh+'0HX t    PEmpire State College Disability Delcaration and Request for Accommodations Form KHERMANN0Disability Declaration, Accommodations RequestNormalMelissa Zgliczynski4Microsoft Office Word@F#@ r@,[@,[+ ՜.+,D՜.+,l px  LSuny Empire State College Document/ PEmpire State College Disability Delcaration and Request for Accommodations Form Title8\ _PID_HLINKSContentTypeId$_ip_UnifiedCompliancePolicyUIAction&_ip_UnifiedCompliancePolicyPropertiesA~*mailto:Disability.Services@sunyempire.edu,0x0101001A35C0F3CF38D140A23A74ED0962E2DF  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXY[\]^_`abcdefghijklmnpqrstuvxyz{|}~Root Entry F[Data )1TableZ)WordDocument 8&SummaryInformation(oDocumentSummaryInformation8wMsoDataStore[y[KLDUKXOA==2 [+[Item  PropertiesOBFMXIOOA2J2FANA==2 [y[Item  5Properties CompObjr DocumentLibraryFormDocumentLibraryFormDocumentLibraryForm This value indicates the number of saves or revisions. The application is responsible for updating this value after each revision. metaAttributes"/>  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q