Special Housing Request

Due in Disability Services by March 2 for the following academic year

You must be approved for accommodations with the Office of Disability Services. Documentation of the disability must be provided to Disability Services prior to the application deadline.
All requests will be prioritized by need. Requests will be reviewed and students will be notified about approval prior to Housing Sign Ups. If approved you and your roommates DO NOT need to participate in Housing Sign Ups.
Any applications received after the deadline will be reviewed based on housing availability.

Last Name
First Name & Mid Init
Email
ID#
Current Level
Please specify the medical, psychological or ADA need and whether the need is temporary or permanent; documentation will be required from a certifying professional who must specialize in the area of the condition or disability and is not a friend of the family or related to the student.
What housing accommodations are you requesting (i.e., ground floor, single, etc.)?
What documentation will you be providing to support your request:
How does the request listed above relate to the need?
What steps have you taken to personally provide for the need?
Please provide acceptable alternatives if the accommodation is not possible.
List your building and floor preferences (first, second, third choices): Please note: You must be at least a Junior in the Fall to be considered for an apartment. 3-person apartments are available for Medical Housing, and only a limited number of 5-person apartments will be available.	1.
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List your proposed roommate(s) (Last, First Name) (ID#) (Current Year): Please note: Apartment roommates must be at least a Junior in the Fall to be considered.