WISCONSIN INDIANHEAD TECHNICAL COLLEGE
Functional Ability Criteria
It is the intent of the Wisconsin Indianhead Technical College (WITC) to fully comply with Section 504 of the Rehabilitation Act of 1973 (29 U.S.
C & 794), the Americans with Disabilities Act (ADA) of 1990 (42 U.S.C & 1201. et seq.), the ADA Amendment Act of 2008. In accordance with
these laws, WITC does not provide students with personal devices and services.
In order to assist students to successfully complete his/her selected program, WITC has developed a set of objective functional ability criteria.
Students will be asked to sign the Functional Ability Criteria Statement of Understanding form stating whether or not they are able to meet the
functional abilities, with or without accommodations, as stated in this document. If a student enters the program based on falsification of
records related to their ability to meet functional requirements, he/she may face disciplinary action. The form signed at admission to the
program will be kept on file in the student’s permanent record. If the student is required to sign the form again at a later date designated by
the program requirements, the signed form will be kept on file in the student’s record maintained by the program director/faculty for five
years, then destroyed.
For students with a disability, reasonable accommodations are available. Reasonable accommodations are defined as modifications or
adjustments that allow individuals with disabilities to gain equal access and have equal opportunities to participate in WITC’s courses, services,
activities, and use of the facilities. To be eligible for disability-related services/accommodations, students must have a documented disability.
This documentation must be provided by a licensed professional, qualified in the appropriate specialty area. WITC is not obligated to provide
an accommodation that requires a substantial change in the curriculum or alteration of an essential element or function of a program /course.
WITC is also not obligated to provide an accommodation that poses an undue financial or administrative burden to the College or poses a direct
threat to the health and/or safety of others.
Accommodations allowed, without disability documentation: supportive back brace or other supportive brace that does not impede required
movement or interfere with infection control policies, hearing aids, glasses, and/or contacts. Other student-suggested accommodations will
require the approval of the Program Director or Academic/Divisional Dean, the campus Accommodation Specialist, and the Wisconsin
Department of Health Services (for Nursing Assistant only). All requests should be approved before the student is enrolled in the program. Any
accommodation cannot substantially alter the requirements or nature of the program or provide accommodations that inflict an undue burden
on the program.
If you are a person with a documented disability and would like to request accommodations, please contact the campus Accommodation
Specialist at the campus number listed at the end of this document or on the Disabilities Pamphlet included in the inquiry packet of
information. Requests are recommended to take place 30-days prior to class start date to allow time for accommodations to be coordinated.
Requests for reasonable accommodation must be made with at least fourteen (14) calendar days’ notice prior to the first day the service is
needed or as soon as possible.
A list of functional abilities the student must have in order to participate in his/her selected program at WITC is attached.
Program Specific Notices:
Criminal Justice – Law Enforcement Academy Students:
If you are an individual with a disability under the ADA and you believe you need reasonable accommodations for the Criminal
Justice - Law Enforcement Academy program, you should contact the Director, Criminal Justice Academy. Course requirements are
based on bona fide occupational qualifications and will not be modified or waived. However, reasonable accommodations may
be provided. In certain circumstances, you may be required to provide documentation for your disability and need for
accommodation. This statement applies to both the classroom and scenario portions of the academy testing process.
Nursing Assistant Students:
The Nursing Assistant program is highly regulated by state and federal law. OBRA, 1987 and State of Wisconsin, HFS 129, 2009
offer specific criteria for how the program will run, what is taught, how it is taught, mandated hours needed to be completed, and
the ability of the nursing assistant to do the work required. In order to assist students to successfully complete the Nursing
Assistant program and achieve certification to work through the Wisconsin Nurse Aide Registry, WITC has developed a set of
objective functional ability criteria. All signed forms will be kept on file at the WITC Division of Allied Health office in Shell Lake,
Wisconsin for three years and then destroyed.
Rev 2/8/2017
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WISCONSIN INDIANHEAD TECHNICAL COLLEGE
Functional Ability Criteria
Statement of Understanding
The Americans with Disabilities Act (ADA) of 1990 (42 U.S.C & 1201. et seq.), the ADA Amendment Act of 2008, and Section 504
of the Rehabilitation Act of 1973 (29 U.S. C & 794) prohibits discrimination of persons because of her/his disability. In keeping
with these laws, colleges of the Wisconsin Technical College System make every effort to ensure a quality education of students.
The purpose of this document is to ensure that students acknowledge that they have been provided information on the
functional abilities required for the program designated below:
Advanced EMT
Architectural Commercial Design
Automated Packaging Systems Technician
Automation for Industrial Systems
Automotive Service Technician
Automotive Technician
Broadband Technologies
Cosmetology
Criminal Justice Studies
Criminal Justice – Law Enforcement Academy
Dental Assistant
Early Childhood Education
E-CHiLD
E-Connect – Child Care Services
Emergency Medical Technician
Emergency Medical Technician – Paramedic
Gerontology – Aging Services Professional
pre-Health Information Technology
Health Information Technology
Heating, Ventilation and Air Conditioning/
Refrigeration (HVAC/R)
Human Services Associate
Industrial Maintenance Technician
IT – Network Specialist
IT – Systems Administration Specialist
IT – Web and Software Developer
Machine Tool Operation
Machine Tool Operation - CNC
Machine Tool Technician
Machine Tooling Technics
Marine Repair Technician
Medical Assistant
pre-Medical Coding Specialist
Medical Coding Specialist
pre-Nursing
core Nursing
Nursing Assistant
pre-Occupational Therapy Assistant
Occupational Therapy Assistant
pre-Paramedic Technician
Paramedic Technician
Phlebotomy
Power Sports Technician
Residential Construction and Cabinetmaking
Welding
This form can be completed at your program admission interview or prior to admission and turned in to Student Services.
________
I have read and understand the Functional Abilities Criteria specific to a student in this program.
________
I am able to meet the Functional Abilities Criteria as presented with or without accommodation.
________
I was provided with information concerning accommodations or special services if needed
at this time.
(initial/date)
(initial/date)
(initial/date)
_______________________________
Name of Student (please print)
Rev 2/8/2017
________________________________
Signature of Student
____________
Date
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WISCONSIN INDIANHEAD TECHNICAL COLLEGE
10-504-5 Criminal Justice Studies
Functional Abilities
GROSS MOTOR SKILLS
• Ability to move in confined spaces
• Maintain balance in multiple positions and when changing positions
• Ability reach above shoulders
• Ability reach below waist
• Extend arms fully forward
• Extend and constrict hands
• Physically Climb
• Physically Stoop
• Physically Kneel
• Physically Crouch
• Physically Crawl
• Physically Twist
• Ability to use hands and arms in handling, installing, positioning and moving materials and manipulating
things
FINE MOTOR SKILLS
• Demonstrate finger dexterity by picking up and/or pinching and manipulating small objects
• Grasp small objects with hands quickly with hard/firm pressure as well as light pressure
• Write legibly with pen or pencil (complete incident reports, statements etc.)
• Maneuver a computer mouse
• Pinch/pick or otherwise work with fingers
• Key/type (complete incident reports, statements etc.)
• Lock and unlock locks
• Squeeze with finger
• Ability to control and adapt pressures of fine motor movements. (weapon control, trigger finger)
PHYSICAL STRENGTH
• Ability to carry equipment and supplies ongoing
• Ability to carry, lift or drag another human body (<100lbs)
• Ability to change, control and adapt upper body strength (lifting full body weight of another person, resisting
others, implementing tactical skills)
• Perform physical activities that require considerable use of your arms, legs, and fine and gross motor skills,
such as:
o Climbing
o Lifting
o Balancing
o Walking
o Stooping/Squatting
o Handling of materials
• Actively dealing with resistive people
• The ability to use short bursts of muscle force to propel oneself (as in jumping or sprinting), or to throw/toss
objects
• Ability to squeeze with hands
• Ability to use self-contained breathing apparatus
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PHYSICAL ENDURANCE
• Have stamina sufficient to maintain physical activity for periods <12-hours
• Stand and/or sit for long periods of time (12-hour shifts)
• Sustain repetitive movements
• Managing the ongoing running, maneuvering, navigating, or driving vehicles or mechanical equipment
MOBILITY
• Ability to move quickly in emergency situations
• Climb and descend a flight of stairs or elevated environment
• Perform physical activities ongoing and day-to-day, such as
o Walk
o Run
o Twist
o Bend
o Stoop
o Squat
o Kneel
o Crouch
o Climb
o Climb stairs
o Crawl
o Turn
o Jump
• Simultaneous use of hands, wrists, fingers and other fine and gross body movements
• Ability to control required eye-hand coordination
• Ability to control eye-hand-foot coordination
• Demonstrate driving coordination
• Ability to quickly respond (with hand, finger or foot)
ENVIRONMENT
• Tolerate exposure to common allergens such as: pets, body lotions, soaps, cleaning products and latex
• Tolerate strong odors
• Tolerate exposure to all weather conditions on a day-to-day basis
• Tolerate confined spaces
SPEECH AND COMMUNICATION
• Speak English clearly
• Write English
• Listen and comprehend spoken and written words
• Read digital displays
• Read and understand written documents (e.g. flow sheets, charts, graphs)
• Exhibit and comprehend nonverbal cues
• Collaborate with others and manage information
• Ability to listen and understand information and ideas presented through spoken words and sentences
• The ability to communicate information and ideas, verbal and written, so others will understand
• Communicate with people outside the organization, representing the organization to customers, the public,
government, and other external sources
• Ability to tell when something is wrong or is likely to go wrong and using verbal and non-verbal skills to
de-escalate situations
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VISION
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Ability to direct, manage, and delegate the activities of others
Ability to influence people
Acuity, Near
Acuity, Far
Read and interpret written data placed at a reasonable distance
Ability to see details at a distance
Ability to adapt to changing depth perception
Ability to use peripheral vision
Distinguish color and color intensity
Possess normal color vision
Possess normal visual functions in each eye. Includes peripheral vision, depth perception, etc.
Possess 20/20 corrected vision in each eye
Ability to see objects or movement of objects to one’s side when the eyes are looking ahead
SMELL
• Detect odors (e.g., foul smelling drainage, alcohol breath, smoke gasses or noxious smells)
HEARING
• Ability to hear normal speaking ranges
• Ability to hear faint noises
• Ability to decipher different sounds
• Hear telephone conversations/radio communication frequencies
• Hear faint body sounds
• Hear in situations when not able to see lips
• Hear auditory alarms
• The ability to listen to and understand information and ideas presented through spoken words and sentences
TACTILE ABILITY
• Feel vibrations
• Feel differences in surface characteristics
• Detect hot and cold temperatures
• The ability to quickly respond (with the hand, finger, or foot) to a signal (sound, light, picture,) when it
appears
• The ability to shift back and forth between two or more activities or sources of information (such as speech,
sounds, touch, or other sources)
READING
• Read and understand written documents
• Understand charts, graphs, and worksheets
• Read and understand digital and computer displays
MATH
• Ability to complete basic math functions such as add, subtract, multiply, and divide
• Ability to read and interpret measurement marks
• Ability to tell time
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Ability to measure time
Comprehend and interpret graphic trends
Compute fractions and decimals
Document numbers in records
Calibrate equipment
ANALYTICAL THINKING
• Transfer knowledge from one situation to another
• Process and interpret information from multiple sources
• Analyze and interpret abstract and concrete data
• Problem solve
• Prioritize tasks
• Sequence information
• Evaluate outcomes
• Use long-term memory
• Use short-term memory
• The ability to listen to and understand information and ideas presented through spoken words
and sentences
• The ability to combine pieces of information to form general rules or conclusions (includes finding a
relationship among seemingly unrelated events)
• Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or
approaches to problems
• Considering the relative costs and benefits of potential actions to choose the most appropriate one under
stressful conditions
• Understanding the implications of new information for both current and future problem-solving and decisionmaking
• Ability to concentrate on a task over a period of time without being distracted
• Identifying measures of indicators of system performance and the actions needed to correct or improve
performance, relative to the goals of the system
CRITICAL THINKING
• Make decisions independently
• Synthesize knowledge and skills
• Sequence information
• Identity cause-effect relationships
• Plan/control activities for others
• Adapt decisions based on new information
• The ability to tell when something is wrong or is likely to go wrong
• Handling complaints, settling disputes, and resolving grievances and conflicts, or otherwise
solving with others
• Giving full attention to what other people are saying, taking time to understand the points being made,
asking questions as appropriate, and not interrupting at inappropriate times
• Adjusting actions in relation to others' actions
• Use relevant information and individual judgment to determine a solution
• Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or
approaches to problems
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EMOTIONAL STABILITY
• Ability to cope with behaviors and physical outbursts
• Ability to cope with own emotions and through stressful situations
• Ability to adapt to changing/unexpected situations and stressful environments
• Focus attention on the needs of others despite interruptions and multiple demands
• Accept constructive feedback and accept responsibility for own actions
• Ability to focus attention on task
• Ability to adapt to changing environment/stress
• Cope and emotionally manage with the unexpected
• Provide others with emotional support
• Establish and maintain professional relationships
• Perform multiple responsibilities concurrently
• Cope with strong emotions in others
• Exhibit ongoing behaviors supporting the following characteristics: honesty, reliability and integrity
• Ability to manage personal finances
• Capacity to remain calm during stressful situations
• Be free from mental or emotional instabilities which may tend to impair the efficient performance of job
duties or endanger the lives of others
INTERPERSONAL SKILLS
• Establish appropriate relationships with clients, families, and coworkers
• Provide others with emotional support
• Collaborate with others on healthcare teams or other community support organizations
• Respect and value cultural differences in others
• Communicate clearly and effectively when introduced to an interpersonal conflict
• Ability to respect alternative life styles
• Ability to work through interpersonal conflict using professional skills and following protocol
• Develop constructive and cooperative working relationships with others, and maintaining
them over time
• Provide personal assistance, medical attention, emotional support and personal care to others in need
• Being aware of others' reactions and understanding why they react as they do
• Take initiative to reach out, serve and support others
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REASONABLE ACCOMMODATION REQUEST FOR STUDENT
SECTION TO BE COMPLETED BY STUDENT
STUDENT REQUEST
Name:
Date of Request:
Student ID#:
Date Accommodation Needed:
College Location: (circle one) Ashland
Hayward
Ladysmith
New Richmond
Rice Lake
Superior
Shell Lake
Describe the disability and how it affects your education:
Accommodation(s) you are requesting:
To ensure the provision of reasonable and appropriate accommodations, the student requesting services must provide
current documentation of their disability. The documentation should provide information regarding the onset and
severity of the disability, as well as describe how it interferes with educational achievement. In order to establish that an
individual is covered under ADA and Section 504 of the Rehabilitation Act of 1973, documentation must demonstrate
that the individual has a disability and it substantially limits and impacts the major life activity of learning. If
accommodations, academic adjustments and/or auxiliary aids are being requested, the documentation provided must
support the request. Appropriate accommodations will be determined based on the specific information submitted in the
documentation. Please attach required documentation to this form. Complaint/appeals information is contained in
Administrative Procedures J-111A, Reasonable Accommodation for Student with Disabilities.
Student Signature
Date
FOR COLLEGE USE ONLY
Accommodation is:
COLLEGE RESPONSE
Approved
Not Approved
Accommodation Plan and Effective Date:
Revisions or changes to above plan and date implemented:
Dean of Students Signature
Date
Reasonable Accommodation Request Form - June 2015
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