Public Accommodation Request

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Student Information

Please enter your information

First Name

Last Name

Middle Name

Student ID

Please use your university issued email address

Phone Number

Specific Accommodation Information

My diagnosed disability falls into the following category

How does your disability affect you academically?

How does your disability affect student life in general?

Please list the accommodations you are requesting

Upload supporting document(s)

To register for accommodations, you will need to submit a recent (within the past three years) official documentation of your diagnosed disability from a licensed professional. Linked Here is a provider documentation form to utilize if needed. Once we receive this documentation, you will meet with an EAC staff member to establish your Accommodation Plan.

Public Accommodation Request

Student Information

Specific Accommodation Information

Document Information