Online Accessible Furniture Request

The Office of Disability Services provides accessible furniture to ensure equal access for qualified MSU students with disabilities.

This form is ONLY for those students who are already registered with the Office of Disability Services. If you have not registered with the Office of Disability Services please visit our For Students page.

Please submit this form online when possible. You may also request a paper version at the Office of Disability Services, 137 Romney Hall.

denotes required fields.

Student Name

Last 4 Digits of Student ID 1234

Student Email Address

Student Phone Number (including area code)

Semester Fall 2019

CLASS SCHEDULE
List only those courses for which you are requesting Accessible Furniture

Course 1 CRN WRIT 101

Course 1 Section 001

Course 1 Location WIL 1119

Course 2 CRN WRIT 101

Course 2 Section 001

Course 2 Location WIL 1119

Course 3 CRN WRIT 101

Course 3 Section 001

Course 3 Location WIL 1119

Course 4 CRN WRIT 101

Course 4 Section 001

Course 4 LocationWIL 1119

Course 5 CRN WRIT 101

Course 5 Section 001

Course 5 Location WIL 1119

Furniture Request

Adjustable Table

Chair for Assistant

Non-standard Desk and Chair

Podium

Stool

Any additional information we need to know about your request (please be as specific as possible)

Confirmation

I have read and accept the responsibilities of requesting accessible furniture from the Office of Disability Services

More Information

Resources

Follow Us