Employee Accommodation Plan Form
A person with a disability means any person who has a physical or mental impairment which substantially limits one or more major life activities.  “Major life activities” means functions such as caring for one’s self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, or working.  If you feel you need an accommodation for your disability, in order for you to perform the essential functions of the job, please complete this form and a representative from the Auburn School District Human Resources Department will get in contact with you.
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Email *
Name
Building
Job Assignment
Phone Number
Disability
Description of your how your disability impairs a major life activity.
What accommodations are you requesting?
A copy of your responses will be emailed to the address you provided.
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