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Accommodation Request Form
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Student Information
Please enter your information
First Name
Required
*
Middle Name
Last Name
Required
*
Student ID
Required
*
Email
Required
*
Please use your university issued email address
Student Mobile Number
Required
*
Accessibility Specific Information
Have you received academic accommodations at a school or university prior to joining AUC?
Have you received academic accommodations at a school or university prior to joining AUC?
Yes
Have you received academic accommodations at a school or university prior to joining AUC?
No
My diagnosed disability falls into the following category
Required
*
How does your disability affect you academically?
Required
*
How does your disability affect student life in general, like taking tests and studying?
Upload supporting document(s)
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Upload File
Emergency Contact
Please provide the contact information of your emergency contact.
Emergency Contact Name
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*
Relationship to Student
Required
*
Mobile Number
Required
*