Center for Social Justice (CSJ) Accommodations Request Form FY20
Accommodation requests related to a disability should be made at least 5 business days prior to the event by filling out this form. Center for Social Justice will consider and make reasonable efforts to fulfill requests for accommodation. Please fill out all questions on this form with as much information as possible. Direct any questions about this form or your accommodations request to Center for Social Justice Executive Director, andria.wisler@georgetown.edu.

Please note this form is supplemental to registration. This form does not serve as the registration.
Email address *
What is your full name? *
Your answer
What is your phone number?
Your answer
What is your primary Georgetown affiliation? *
What is your accommodations request? Please use as much detail as necessary so that we can thoughtfully respond to your request. *
Your answer
For what Center for Social Justice event(s) and/or program are you seeking accommodation? *
Your answer
Please include the date(s) and time(s) for the event(s).
Your answer
Have you already registered/rsvp-ed for the event/program?
Next
Never submit passwords through Google Forms.
This form was created inside of Georgetown University. Report Abuse