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Living and Learning Accommodation Application

NOTE: Use this application for accommodations related to COVID-19.

The accommodation application must be completed for each academic year.


* indicated required fields

Request for Accommodation



Contact Information










Local Address





Permanent Address





Academic Profile





Accommodation information  be shared or discussed with other Northwest departments and your parents.

Specifications




Yes     No




*****  ALERT  *****

Before your application is considered complete, you must send an email to ada@nwmissouri.edu with your medical or counseling professional’s supporting documentation including accommodation recommendations (on their letterhead and signed).

Please enter your initials in the Signature field below which constitutes your intent and authorization to submit the accommodations application.


 

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