Request for Disability Services
*All Interpreter Request must be submitted 3 days prior to the scheduled event *
TSC ID
Your answer
Student/Staff Name
Your answer
E-Mail Address
Your answer
Phone Number
Please enter number in the following format: (###) ###-####
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
College Major
Your answer
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:
Your answer
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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