Accommodation Request Form

* indicates a required field

Student Information

Please note this submission of this request is not a guaranteed approval of accommodations. Students will be required to meet with staff to discuss accommodation requests to determine approval.

Your application cannot be processed without your Jackson College Student ID and Jackson College Email. To find this information please visit the Jackson College Admissions Page here: https://www.jccmi.edu/admissions/orientation/

Please use your Jackson College issued email address. (e.x. ChipsJohnC@my.jccmi.edu)
Preferred Method of Contact
What county do you reside in?

Specific Accommodation Information

Have you applied to live in JC Housing?Required
Grievance ProcedureRequired

Please read our Grievance Procedure before submission of this form.

https://www.jccmi.edu/wp-content/uploads/GRIEVANCE-PROCEDURE.pdf

Accommodations CriteriaRequired

Please read our Accommodations Criteria before submission of this form.

https://www.jccmi.edu/center-for-student-success/accommodations-for-students-with-disabilities/#jc-tabs-1-tab-1 

Permission to notify Jackson College EmployeesRequired
Upload supporting document(s)
Verifiable documentation is required; examples of documentation include medical documentation from a licensed medical practitioner, Individual Education Plans, or 504’s. They are used as guidance as some accommodations do not carry over from high school to college.