OFFICE OF ACCESSIBILITY SERVICES

Division of Student Affairs


Accessibility Form Application


Personal Information
*
*
(Check all that apply)
Contact Information
(Street Name)*
@jjay.cuny.edu
How You Got To Know Us
(Check all that apply)
Veteran Information

Allowed file types word and pdf documents
Enrollment/Academic Status
Disability-related Information

Disability Status

Please provide the physician's contact information

Assistive Technology & Alternative Textbooks

Requesting Accommodation For the Classes Below
Course Code Section Day(s)/Time Instructor Room # Action