Applicant Disability Accommodation Request

Section

For questions, please email adarequest AT_TOWSON or call 410-704-2162

(* is required)

Name:

Phone:

Email:

Please describe in detail how your disability affects your ability to participate in the application process:

Requested Accommodation(s):

If an accommodation is needed for an interview or on-site visit please indicate the date and location/department.

Date Accommodation Needed:

Location and Department for Needed Accommodation:

NOTE: Medical documentation from a treating medical provider may be requested as part of the interactive process.