Accommodation Request Form

Students who have completed an intake appointment with the ADRC and provided appropriate disability documentation may request their accommodations via this electronic form. If you have any questions regarding this form, please contact the Access & Disability Resource center at 847.635.1759 or

* = required field

Accommodation Request Form:

Please complete this information for every course you are requesting accommodations; incomplete or inaccurate information may delay the process.

Class 1

Class 2

Class 3

Class 4

Class 5

* I have had an intake session with an ADRC staff member.

* I have submitted my documentation.

I am approved for and requesting:

Please note: Accommodations are processed on a first-come, first-served basis. Some may take several weeks to arrange. If you make changes to your schedule, you must fill out a new form.


*By clicking submit below, I hereby grant the ADRC staff permission to email my instructor(s) for the courses I have listed above, about my requested and approved accommodations. I understand that I will receive a copy of the communication sent to my instructor(s), and that it is my responsibility to follow up with them regarding these accommodations.