Continuing Services (Non-Academic Accommodation Request)

Continuing Services

Non-Academic Accommodations Request
Please complete this form to notify Accessibility Services of a request for housing or other non-academic accommodations you would like for the semester/academic year. (Please Note: Academic years begin in the fall semester and end after the Spring semester. Requests for summer housing accommodations need to be made separate from requests for the academic year.)
Semester
Semester services will begin:*
Student Information
Preferred Name:*

First NameLast Name
S#: *
S00000000
Email*
example@example.com
Accommodation Request
Accommodation request for:*

Emotional Support Animal (ESA)HousingDiningStudent and/or Campus Event
If you are requesting an Emotional Support Animal (ESA) accommodation, please explain your disability and how the ESA would benefit you.
If you are requesting a Housing accommodation, please explain your disability and what kind of adjustment or accommodation is needed.
If you are requesting a Dining accommodation, please explain your disability and what kind of adjustment or accommodation is needed.
If you are requesting Student Event or Other Campus Event, please explain your disability and what kind of adjustment or accommodation is needed. Additionally, please state what specific event and, if possible, who is responsible for the event (such as a department or a club). Note: There may be a delay in your request if the event is not identified.
Should be Empty:

Continuing Services