Student Name
Temporary Street Address
City
Zip Code
Current Phone
Date you will vacate this address
Permanent Street Address
City
Zip Code
Permanent Phone
Applying as:
Term you wish to start:
Academic Year
I am interested in the following academic program:
Physical Disability Services
(Please contact the Access Center )
Students with disabilities who are requesting support services in the form of academic accommodations or auxiliary aids from CLASS are required to submit documentation to verify eligibility under section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA) of 1990. All information obtained by the CLASS Program is kept strictly confidential and will not be released without written consent of the student. For more specific information please review the CLASS Policy on Documentation of a Disability.
If you have any questions about or wish to contact Augsburg College Admissions, click below:
http://www.augsburg.edu/about/admissions.html - Augsburg College Admissions
The content of this web page has been developed and published by CLASS Augsburg College
Minneapolis, Minnesota 55454 USA.
This page updated 9/5/05
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