Request for Reasonable Accommodation Form for FFA Events

Request for Reasonable Accommodation Form for FFA Events

New Jersey FFA Association
The New Jersey FFA Association is committed to providing equal access to our events and activities for all people. Use this form to request a reasonable accomodation or assistance at least 3 weeks before any state-level events. A new form will need to be submitted for each event in which a reasonable accommodation is being requested. This information will be kept confidential and will be used only to process the request. Our staff will review the request upon receipt and contact the requestor with additional information. The association cannot guarantee accommodations or assistance if a form is received less than 3 weeks before an event. Accommodations being requested that require the assistance of another person (nurse, interpreter, scribe, reader, etc.) is the responsibility of the school/requestor. It is also the school/requestor's responsibility to provide any approved equipment to aide in the accommodation process, if applicable.
Today's Date*

MonthDayYear
Date
Are you completing this request for:*
Reason for completing this form:*

ADA Accommodation RequestAllergy NotificationSpecial Dietary RequestSpecial Request/AccommodationOther
Please list allergy and the type of exposure that causes the reaction (ingested, contact, inhaled, etc.)*
Participant's Name*

First NameLast Name
Participant's Phone Number*
Please enter a valid phone number.
Parent/Guardian's Name, if participant is under 21 years of age:*

First NameLast Name
Parent/Guardian's Email*
example@example.com
Parent/Guardian's Phone Number*
Please enter a valid phone number.
Chapter Name*
Advisor's Name*

First NameLast Name
Advisor's Email*
example@example.com
Advisor's Phone Number*
Please enter a valid phone number.
Select the Event*
Explain Other*
Please describe the limiting nature of the disability.*
Please describe the accommodation(s) you are requesting. If request is allergy related, share to what type of exposure is the reaction related (ingested, contact, inhaled, etc.).*
Please list accommodation(s) provided at the local level.*
Should be Empty: