Accommodation Request

* indicates a required field

Student Information

Please enter your information
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Please use your Eckerd issued email address
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Are you requesting academic accommodations?(Required) *
Example: Extended Time for Tests
Are you requesting a meal plan accommodation?(Required) *
Example: Food Allergies
Are you requesting an Emotional Support Animal (ESA) as an accommodation?(Required) *
Example: Emotional Support Animal
Are you requesting a housing accommodation?(Required) *
Example: Ability to have specific room accommodation

Specific Accommodation Information

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Check all that apply
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