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Room and Board Accommodations Request

Students with disabilities or medical conditions that require accommodations must complete this form and submit it to the Disability Services office each academic year if they plan to live on campus. Students will be notified in advance if more current documentation is needed each subsequent year a housing accommodation is requested. In addition, the College, acting in good faith, reserves the right to request updated documentation at any time.

Services may include

If you would rather print out a copy of the form and hand it in to the Office of Disability Services at Henry Pfeiffer Library Room 103, you may use a PDF copy (PDF).

Fields marked with an asterisk (*) are required.

Student Information

Request Information

For which academic year are you applying?

I am requesting (check all that apply):*


Air-conditioned rooms and single rooms are limited and are on a first come, first served basis.

Leave this field blank.