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Study of the Mount Diablo Unified School District - Mt. Diablo Unified ...

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Policies, Procedures, and ComplianceEXHIBIT 4‐1SAMPLE NOTICESECTION 504 OF THE REHABILITATION ACT OF 1973AND THE AMERICANS WITH DISABILITIES ACTNOTICE TO OUR SCHOOL COMMUNITY(NAME OF SCHOOL CORPORATION)(Name <strong>of</strong> <strong>School</strong> Corporation) is committed to complying with <strong>the</strong> requirements in Section504 <strong>of</strong> <strong>the</strong> Rehabilitation Act <strong>of</strong> 1973 and <strong>the</strong> Americans with Disabilities Act. We areseeking information from adults with disabilities in our community relative to <strong>the</strong> following:1. Do you have a physical or mental disability, and do you have a child enrolled in ourschool? (Are you deaf, have a physical disability, or serious medical condition(s),etc.)? YES _____ NO _____We are responsible for providing you access to parent‐teacher conferences ando<strong>the</strong>r programs and activities including graduation.2. Are you or do you know <strong>of</strong> an individual with a disability that may attend a functionin our building (i.e., graduation ceremony)? We would like to be aware <strong>of</strong> this incase <strong>the</strong>re are physical barriers in accessing our building. YES _____ NO _____Please provide <strong>the</strong> following information so that we can provide you access to ourfacility, programs, and activities. All responses will be kept confidential.____________________________________________ ________________________NAMEPHONE NUMBER______________________________________________________________________ADDRESSThank you.Sincerely,Building PrincipalSource: A Public <strong>School</strong> Manual (2007), M. Livovich.MGT <strong>of</strong> America, Inc. Page 4‐3

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