Request for Disability Services
*All Interpreter Request must be submitted 3 days prior to the scheduled event *
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TSC ID *
Student/Staff Name *
E-Mail Address *
Phone Number *
Please enter number in the following format: (###) ###-####
Street Address *
City *
State *
Zip Code *
College Major *
Are you receiving services from the following agencies?
What is your disability?
To equalize my chances of success in the classroom, I would benefit from the following accommodations:
I give my permission for the above information to be made available to my instructors, the college administrator, and other individuals employed by Texas Southmost College who require information to provide for my educational needs. *
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