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Get American Disability Act Accommodation Request Form ...

Dance with the Americans with Disability Act (ADA). Name Date of Request Campus Address Campus Phone Number Department Classification/Position Title Please answer the following questions to assist the agency in understanding the basis and nature of your request for accommodation. The information you provide will be treated confidentially and will be handled on a need-to-know basis. What are the essential duties and responsibilities of the position which will be or are affected by your disab.

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