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Accommodation Request Form

The Office of Academic AccessAbility arranges academic, residential, and dining services accommodations for qualified students with disabilities. Please note that Greensboro College requires documentation of your disability.

Once the appropriate documentation is received, your request will be reviewed to determine eligibility for the requested accommodations. If you have questions about documentation guidelines, please contact the Office of Academic AccessAbility, 336-272-7102, ext. 5591, or email georgieann.bogdan@greensboro.edu. The fax number is 336-271-7217.

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Student Name(Required)

Date(Required)

Student GC Email(Required)

Cell Phone(Required)

Student ID Number(Required)

Type of Accommodation(s) Requested(Required)

Academic

Housing

Dining

Please briefly explain diagnosis and limitations(Required)

Please describe the accomodation(s) you request(Required)

Electronic Signature(Required)

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