Accommodation Request
Accommodation Request
Name
Name
*
First
Last
Email
*
Cell Phone
Cell Phone
*
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-
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UNH ID No.
*
Campus
*
Campus
West Haven/Orange
Lyme
California
Qatar
New London
Alebquerque, NM
Prato
Academic Year
*
Semester
*
Semester
Fall
Spring
Summer
Intersession
Check your request(s) below
This is the description of your section break.
Course name (ex: Composition)
*
Course Number & Section (ex: E105-01) List days and times if section is not known
*
Instructor's Name (if not know list STAFF)
*
Request
*
Request
Letter to instructor
Note taker in class
sign language interpreter
Other
Other
Course name (ex: Composition)
*
Course Number & Section (ex: E105-01) List days and times if section is not known
*
Instructor's Name (if not know list STAFF)
*
Request
*
Request
Letter to instructor
Note taker in class
sign language interpreter
Other
Other
Course name (ex: Composition)
*
Course Number & Section (ex: E105-01) List days and times if section is not known
*
Instructor's Name (if not know list STAFF)
*
Request
*
Request
Letter to instructor
Note taker in class
sign language interpreter
Other
Other
Course name (ex: Composition)
*
Course Number & Section (ex: E105-01) List days and times if section is not known
*
Instructor's Name (if not know list STAFF)
*
Request
*
Request
Letter to instructor
Note taker in class
sign language interpreter
Other
Other
Add additional information here:
*