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Get Request For Accommodation - Indiana State University

Rm is to document your request for reasonable accommodation to enable you to perform the essential functions of your job. In order to evaluate your request, we will need information regarding your disability, your functional limitations and your requested accommodation(s). Please complete and return this form to the Office Affirmative Action, Parsons Hall, 223, and forward a copy to the supervisor. General Information Name (Last) (First) (MI).

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