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Accessible Information Request Form

Date
Date
First Name
Name of person filing request
Last Name
Address Line 1
Street address
Address Line 2
e.g. apartment number, suite number
City
State
Zip Code
Email Address
Phone Number
Is this form being completed by an employee on behalf of the requester?
1. Yes
2. No
What is the nature of your accessibility needs?
e.g. low vision, difficulty reading/understanding content, hearing loss, wheelchair access
What material are you attempting to access?
e.g. Board of Trustees agenda for 11/15/2022
If applicable, what is the web address of the content you are trying to access?
What is the preferred format in which you wish to receive accessible material?
e.g. Word document, described over the phone
Other ways to request accessible information
Users who need accessibility assistance can also contact us by phone through the Federal Information Relay Service at 1-800-877-8339 for TTY/Voice communication. If you would like to email a specific department, please find contact information in our staff directory.

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1. Receive an email copy of this form.
Email address

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