Non-Academic Accommodation Application
Please complete this form to notify Accessibility Services of a request for housing, dinning or other non-academic accommodations you would like for the semester.
Semester
Semester services will begin:
*
Please Select
Spring
Summer
Fall
Student Information
Preferred Name:
*
First Name
Last Name
Preferred Pronouns
He/ Him/ His/ She/Her/Hers/Them/They'Thiers
S#:
*
S00000000
Date of birth:
*
(MM-DD-YYYY)
Phone Number
*
Please enter a valid phone number.
Personal Email
*
example@example.com
Otero Email
example@example.com
Accommodation Request
Accommodation request for:
*
Emotional Support Animal (ESA)
Housing
Dining
Student 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.
Please upload any relevant documentation of your disability.
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