Initial Accommodation Request

* indicates a required field

Student Demographics

Please provide the following information about yourself:
(ex. B00XXXXXX)
Click on all the disabilities that apply to you. If you do not see your disability listed and/or are unsure, please select 'Other' and enter your disability in the space provided below.
{"display_name":"My diagnosed disability falls into the following category","hidden_field_name":"ms_field_1","init_id":"ms_field_1","init_link":"","has_autocomplete":false,"has_hierpicklist":null}
Example: Fall 2023
Are you registered to vote?
Upload your Documentation of Disability