Accommodations - Request Form

NMU IN:

First Name:

Last Name:

E-mail Address:

Street Address:

City:

State or Province:

ZIP:

Phone Number:
- -

Semester Requesting:

Courses needing accommodations:

Course: (ex. EN111)

Professor:

Accomodation(s) requested for this course:
Extended test time
Alternate testing site
Books in an alternate format
Note taker
Test reader
Test scribe for essay tests
Other

Add a course (up to 5)