Quicklinks
- Select a Link -
About Messiah
Academics
Admissions
Athletics
Events
Campus Offices
Ministries
Philadelphia Campus
MC Square
|
Search
Content Navigation :
Home
Director's Welcome
Student Information
Faculty Information
Policies
Disability Related Links
Disabilities:
Attention Deficit
Learning Disability
Hearing
Vision
Health/Mobility
Speech/Language
Psychological
TBI
Forms :
- Select a Link -
Survey of Support Needs
ADHD Self-test
Special Housing
Alt Text Request
New Student Form
Self Refer-Current Students
Seizure Form
Employee ADA Form
Dietary Housing
Medical Response Plan
Service Animal Registry
Release of Information
Related Links:
- Select a Link -
Academic Supports
Career Info
Coaching
E-Text Info
Parent Info
Registry for Service Animals
Date of Arrival on Campus
(mm/dd/yy)
Date of Departure from Campus
(mm/dd/yy)
Full Name
Campus Residence Bldg. & Room
Campus Phone
Home Address
City
State
Zip
Home Phone
Cell Phone
Email
Status on campus
Student
Faculty/Staff
Guest
Parent
Conference/Program
Other (specify below)
Name of animal
Type of animal
Services animal provides
If the length of time the animal will be on campus is 7 days or less, you do not need to complete the rest of this form. Please continue if the animal will be on campus more than 7 days. If a service animal will be used on campus for more than 7 days, submit documentation of the disability requiring this accommodation along with this registration form.
Information about the Service Animal:
Identifying tags or accessories:
Date of most recent vaccinations
(mm/dd/yy)
Training agency
(Send copy of certificate to Disability Services, Box 3019)
Maintenance plan
Handler will maintain
Other (specify below)
Other important information
Messiah College | One College Avenue | Grantham, PA 17027 | 717-766-2511
Comments or questions? Contact the
WebMaster
.
© 2009 Messiah College
