Disability Accommodation Request

* indicates a required field

Cecil College Student Information

If you have not been assigned a Cecil ID, please enter your birth date in the following format: MM/DD/YYYY.

Date of Birth Required
Example: he/him, she/her, they/them, etc.
Enter the semester and year you plan to graduate (best estimates are fine)

Student Contact Information

If you have not been assigned a Cecil email, please enter your personal email. Note that this will be overwritten as soon as you are assigned a Cecil email.

Email Format: yourinfo@chawk.cecil.edu

Emergency Contact Information

Accommodation Request Details

Select all that apply
(In class, during exams, reading/writing, group work, etc.)
Example: In K-12 as part of an IEP or 504 plan; From another college or university previously attended.
Will you need accommodations for the Math or English Skills Assessments?Required
Enter the semester and year you would like to start using services.

Additional Questions:

Are you part of the Early College Academy, or dually enrolled in high school and at Cecil College?Required
How did you learn about the Accessibility Services office? Required
Which of the following would you like to learn more about? (select all that apply).
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Will you need physical assistance to be evacuated during an emergency? Required
Assistance Notification Required

We maintain a notification list of students who may need assistance if access to a building is affected due to malfunction or campus maintenance. Please select if you would like to be included on this notification list.

Are you attaching documentation with this application?Required

Appropriate documentation from a qualified provider is required in order to receive accommodations. If you are unable to provide documentation at this time, an email will be sent to you with instructions for submitting documentation.