Accommodation Request Form

* indicates a required field

Shippensburg University is committed to being responsive to the needs of students with disabilities. Please respond to the  items below. If you have any questions or concerns, contact the Office of Accessibility Resources (OAR) located in Mowrey Hall 252.  Phone: (717) 477‐1326 or (717) 477‐1329.

Please use your university issued email address

Specific Accommodation Information

What accommodations are you requesting?Required

Accessibility Accommodation

Nonacademic
No
Nonrenewable
If set to yes, this accommodation will not appear as an options for renewal. If you would like this accommodation to be renewable through a certain date, please enter an expiration date below.
No
Upload supporting document(s)
Agreement

By submitting this form you understand the following:

You must submit appropriate documentation to the Office of Accessibility Resources for review. Original Evaluation  Reports must confirm the history of disability; recent Reevaluation Reports are highly preferred. Professional letters  from a treating physician, therapist, or specialist must meet criteria. Documentation on a prescription pad is NOT  acceptable. An IEP and/or Section 504 Plan is not acceptable as sole source documentation.  The Office of Accessibility  Resources coordinates accommodations and does not monitor or provide life coaching.