Accommodation Request

* indicates a required field

Student Information

This form is for students with a documented disability who want to register for reasonable accommodations and services with Disability Services. When completing the form, please answer the questions as accurately and thoroughly as possible so that we may process your request in a timely manner. Once the application and supporting documentation are completed, your application will be reviewed and you will be contacted within 7-10 business days to schedule an intake meeting. Accommodations are not applicable until you schedule and attend the intake meeting. If you have any questions while completing the form, please contact us at accommodations@saintpeters.edu.

First Name

Last Name

Middle Name

Student ID

Please use your university issued email address

Phone Number

Academic History and Prior Accommodations or Services

Did you previously receive accommodations in high school or at another institution?

My diagnosed disability falls into the following category

In your own words, please describe how your disability affects you academically

In your own words, please describe how your disability affects your major life activities

(such as walking, talking, breathing, etc.)

What accommodation(s) are you requesting?

Upload supporting document(s)

Please review the documentation submission guidelines to ensure you have met the qualified requirements for supporting documentation.

Accommodation Request

Student Information

Academic History and Prior Accommodations or Services

Document Information