Request for Disability Services
*All Interpreter Request must be submitted 3 days prior to the scheduled event *
Please enter number in the following format: (###) ###-####
Are you receiving services from the following agencies?
Texas Commission for the Blind
What is your disability?
Interaction with others
Limited use of hands
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.
I do not agree
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service