Student Accommodation Request Form

Student Information

Following the completion of the Student Accommodations Request Form, students are required to submit documentation that can attest to their specific diagnosis/condition. Please see the guidelines below for appropriate forms of documentation.

First Name

Last Name

Student ID

Email

Please use your DCCC issued email address

Preferred Name

Pronouns

Are you currently registered for courses?

Enrollment Status

What is your current enrollment status?

Please select at most 2 options.

Conditional Information

Please complete all required sections

How would you classify your condition(s)? Please select all that apply

Other

Accommodations Information

Please complete all required portions. If unsure, select/specify N/A

Have you previously received accommodations via another school/college?

Which accommodations are you seeking? If unsure, please specify N/A.

Have you emailed your documentation to accommodations@dccc.edu?

Please monitor your school email for next steps. You can choose to provide an alternate email here if you prefer

Student Accommodation Request Form

Student Information

Enrollment Status

Conditional Information

Accommodations Information

Document Information