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Disability Accommodation Request
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Student Information
Please enter your information
First Name
Required
*
Last Name
Required
*
Middle Name
Email
Required
*
Please use your Bucknell email address. If you do not have a Bucknell email address, please use a personal email.
Phone Number
Required
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Are you a current Bucknell University student or have you been admitted to Bucknell University?
Required
*
In order to apply for accommodations - a student should first be admitted to Bucknell University.
Are you a current Bucknell University student or have you been admitted to Bucknell University?
Yes
Are you a current Bucknell University student or have you been admitted to Bucknell University?
No
Bucknell ID
Required
*
Your Bucknell ID number can be found on the Application Checklist on the Admissions Portal or on myBucknell.
Specific Accommodation Information
Please describe your disability.
Required
*
How does your disability affect you in and out of class?
Required
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Describe the accommodations you are requesting
Required
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Have you previously used accommodations at school or work?
Have you previously used accommodations at school or work?
Yes
Have you previously used accommodations at school or work?
No
What accommodations have you used previously?
When did you last use accommodations?
Upload supporting document(s)
Documentation requirements:
Academic Accommodations
Housing Accommodations
Dining Accommodations
Please check the Housing Accommodation page for deadlines on Housing Accommodation Requests. Although students can request housing accommodations at any time, if the request is after the deadline--even if approved--there are no guarantees.
Document Information
Document Title
Required
*
File
Required
*
Maximum file size: 10240kb
Description