Student Accommodation Request

Student Information

Please enter your information

First Name

Middle Name

Last Name

Student ID (S-number)

Please enter your S-number with no dashes or spaces between characters.

Phone Number

Date of Birth

AUM Email

Please use your university issued email address

Address

City/State

Zip Code

Class Level

Referral Source

Are you working with a VR or VA counselor?

Specific Accommodation Information

My diagnosed disability falls into the following category:

Duration

What is the nature of your disability?

How does your disability impact your life as a student?

Have you received accommodations in the past? If so, what accommodations did you receive?

When would you like to begin receiving accommodations? (List the semester and year i.e. Summer 2020)

Permissions

I give CDS permission to discuss information with non-university individuals (parents, guardians, spouses, etc.)

Disclosing Information

I understand that there are specific but rare instances when information regarding the nature of my disability may need to be disclosed to an advisor, instructor, and/or administrator in order to facilitate legitimate university processes, including but not limited to granting reasonable accommodations, addressing direct threats, or investigating claims or charges.

Upload supporting document(s)

Please click here for our documentation criteria.

If you you have any documentation with the last 3 years, please upload that, as it may suffice rather than having to complete all the requirements noted in the documentation criteria.

NOTE: We highly recommend uploading your documentation here through our secure portal. Submitting documentation at a later date can sometimes prolong the accommodation request process. Please let us know if you have any questions or concerns by emailing cds@aum.edu.

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Student Accommodation Request

Student Information

Specific Accommodation Information

Permissions

Document Information