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Living and Learning Accommodation Application

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.


*Have you received any accommodations in the past at Northwest?

*****  ALERT  *****

Before your application is considered complete, you must send an email to 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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