Accommodations Application/Initial Excuse Request Form

Select the excuse categoryRequired *

[select]Death in the Family Jury Duty/Court Military Duty University Authorized Business Verified Illness clear

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Disability typeRequired *

[select]Hearing Learning Medical Physical Psychological Visual clear

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Are there other accommodations needed other than in the classroom?

Are there other accommodations needed other than in the classroom? Yes Are there other accommodations needed other than in the classroom? No

Are you currently receiving services through the Department of Rehabilitation Services?

Are you currently receiving services through the Department of Rehabilitation Services? Yes Are you currently receiving services through the Department of Rehabilitation Services? No

Are you participating in campus organizations?

Are you participating in campus organizations? Yes Are you participating in campus organizations? No