麻豆直播

Disability Furniture Form

Furniture Accommodation Request

Name

First Last

麻豆直播 ID

Email

Semester

What day(s) of the week is your class

Monday

Tuesday

Wednesday

Thursday

Friday

Course(s) and Classroom Location(s) (Example: ENG 100, Room 123)

Furniture Requested

Ergonomic Chair

Height-Adjustable Desk/Table

Please describe your need for this furniture:

Acknowledgment

I am registered with the Office of Disability Services.

I understand that submission of this request does not guarantee approval and that ODS may contact me for additional information.