Student Accommodation Request Form

* indicates a required field

Student Information

Students requesting disability-based accommodations are invited to complete this form. Once the form is submitted, you will receive instructions on the next steps.

Please use your maine.edu email address
For degree seeking students, your home campus is the campus from which you are getting your degree. For non-degree students your home campus is the campus from which you plan to take the majority of your classes.

Specific Accommodation Information

Select all that apply.
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Do you require accommodations for an initial meeting?Required
Are you requesting accommodations forRequired
Are you requesting housing or ESA accommodations at USM or UMaine but not enrolled in classes at that institution?Required
Upload supporting document(s)
If available, please upload any supporting documentation here.