ACCOMMODATION FORM - Anciens Et Réunions</h6>

Employee Request for Accommodation Form

The purpose of this form is to assist Institutional Equity in determining whether, or to what extent, a reasonable accommodation for an employee with a disability is required to perform one or more essential functions of their job safely and effectively The employee must initiate this request for an accommodation The information will be treated

VA0857a, WRITTEN CONFIRMATION OF REQUEST FOR ACCOMMODATION

11 IF ACCOMMODATION IS TIME SENSITIVE, PLEASE EXPLAIN BELOW 12 NAME OF LRAC 13 PHONE NUMBER OF LRAC An oral request from an employee is sufficient to begin the reasonable accommodation process Completion of this form is voluntary However, individuals who have requested an accommodation are asked to fill out this form for record-keeping

Consent Form for Accommodations Request

This form should be used when a request for accommodation(s) is submitted electronically (via SSD Online) The form should be maintained by the school with the student’s records It does not need to be sent to the College Board You will be asked to verify that a signed Consent Form is on file at the school

Request for Reasonable Accommodation - California

Accommodation Coordinator (RAC) and the Human Resources Coordination Committee (HRCC) for the purpose of assessing employee requests for Reasonable Accommodation It is extremely important for the employee to complete the form with accurate information Failure to supply the requested information will delay processing of your request

Reasonable Accommodation Request Form - Wisconsin

Reasonable Accommodation Request Form Employee: Complete this form if you have a physical or mental impairment that (1) makes achievement unusually difficult or limits the capacity to work (s 111 32(8), Wis Stats ) and (2) may be removed through the pr ovision of a reasonable accommodation

VA0857a, WRITTEN CONFIRMATION OF REQUEST FOR ACCOMMODATION

9 ACCOMMODATION REQUESTED (Be as specific as possible) 10 REASON FOR REQUEST 11 IF ACCOMMODATION IS TIME SENSITIVE, PLEASE EXPLAIN BELOW Employees should give this form to their immediate supervisor or the LRAC 12 NAME OF LRAC 13 PHONE NUMBER OF LRAC 14 LOG NUMBER ASSIGNED

Reasonable Accommodation Handbook Chpt 4 Initiating Requests

Form HUD-22006, "Accommodation Request for Persons with Disabilities" (see Appendix 2) If the requesting individual fails to complete the Form HUD-1000, the supervisor, manager, DPM or Human Resource Specialist receiving the reasonable accommodation request must complete the form on behalf of the requesting individual 4

Accommodation Advisor Packet— Walmart/Sam’s

STEP 3: Job Adjustment (JA) Review and Approval—Any request for accommodation should first be reviewed as a job adjustment [refer to the Accommodation in Employment (Medical-Related) Management Guidelines] If approved at facility level, please complete the attached Facility Job Adjustment Approval Form The form can be

TASC Test Accommodations Request Form

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