Public Accommodation Request

Student Information

The Office of Accessibility Services (OAS) reviews and coordinates accommodations to ensure equal access to the College’s programs, services, and facilities for students with permanent and temporary disabilities.

Current and incoming students may connect with the OAS if they are interested in requesting accommodations, exploring the accommodation request process, or just identifying as a student with a disability. We encourage students to connect with us as early as possible, but they are welcome to submit an application at any point during their time at the SUNY Geneseo. To connect with the OAS and/or request academic accommodations, please complete the form below.

*Please note, students requesting housing and/or Emotional Support Animal (ESA) accommodations must follow the OAS Steps for Requesting Housing Accommodations or ESA Request process.

First Name

Last Name

Preferred Name/Pronouns:

Student ID

G00

Email

Please use your university issued email address

Phone Number

Transfer Student?

Student Status

Major

Student History

Please indicate your current documented disabilities/diagnoses

Have you been diagnosed with a disability or health condition? If yes, please list diagnoses below. If no, please explain why you think you might have a disability.

If known, approximately what age were you diagnosed?

Please describe how your disability impacts your ability to function in the following settings:

Academic

Social/Personal/Living Environments

Mobility around community/campus environments

Are you served by any of the following agencies?

Agency Information

If you selected any of the agencies above, please list your caseworker, phone number, and name of the agency here

How did you hear about us and our services? (select all that apply)

Other (please specify):

Accommodation History

Did you have an Individualized Education Plan (IEP) or 504 plan and receive accommodations in high school?

Please list the accommodation(s) and/or auxiliary aids/services/assistive technologies you have used in the past:

Please list the accommodation(s) and/or auxiliary aids/services/assistive technologies you are currently requesting:

More information about academic accommodations is on our website. Noting items on this list does not necessarily guarantee their approval. Final determination will be made by the OAS staff.

Which semester are you requesting these accommodations for?

College Readiness and Strengths

How would you describe your study habits?

What are your least difficult subjects?

What are your most difficult subjects?

Which of the following do you have difficulty doing?

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What were (are) your strengths in school?

What campus offices/resources have you utilized, or wish to know more about (check all that apply)?

Documentation

If you have documentation of your disability and history of accommodations, please attach it below. You may also send documentation to the Office of Accessibility via email, fax, mail, or in-person:

Office of Accessibility Services

SUNY Geneseo

1 College Circle, Erwin Hall 22

Geneseo, NY 14454

access@geneseo.edu

(p)585-245-5112

(f) 585-245-5091

Please refer to our Documentation Guidelines for more information on appropriate documentation. We recognize some students may not have access to documentation for a variety of reasons. No student should delay meeting with the OAS out of concern for not having access to documentation. Students who do not have documentation may still submit a request form and schedule a meeting. Requests for documentation will be determined on a case-by-case basis

Voter Registration

The OAS is a voter registration site. Please refer to the NYS Board of Elections website for information on registering to vote. Do you require assistance with registering to vote?

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