Accommodation Request Form

* indicates a required field

Student Information

Please enter your information
Please use your university issued email address
Date of Birth
Are you currently on academic probation?
Are you a veteran?
Are you a client of the Division of Rehabilitation Services?
Are you in the AIMSS progam?

Specific Accommodation Information

Please submit your completed registration form below.

Completion of this form alone does not warrant accommodations. Through individual consultation we engage in an interactive process with each student to understand how his or her disability intersects with the institutional environment, and how accommodations would reduce barriers while not fundamentally altering essential components of the course, program, activity, or experience. Essential functions, tasks, standards, and requirements of each class, major, or program cannot be removed or waived. If you are not contacted within 2-3 business days, please call 304-367-4543 to schedule an intake. As mentioned above, there are times when we experience intermittent delays in email correspondence, so this will ensure prompt attention to your request for services. Thank you!

(i.e. reading, writing, concentration, memory, time management)

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Students requesting housing accommodations also need to complete a Housing Application, which can be found by logging onto myFairmontState and clicking on the housing icon.
Please review and check each box indicating you agree with each statement.
Upload supporting document(s)

The student's disability must be diagnosed by a qualified professional and include a clear statement of the diagnosis. Documentation should be no more than 3 years old. The documentation should include the student's needs, the impact the disability has on the student, and recommendations for reasonable accommodations. Appropriate documentation may be one of the following: a letter from a health care provider that is typed, on letterhead, and recently dated; Neuropsychological, psychoeducational, and medical evaluations; or Audiograms, eye exams, etc. Further information can be found on the Office of Accessibility Services webpage.