COVID 19 Related Temporary Accommodation Request Form

This form is for any student that may need COVID-Related temporary accommodations. This form will inform the Student Success and Housing and Residence Life Offices of the accommodations that you are requesting.

First Name:

Last Name:

Student ID Number (Please enter in the format P000123456):

Student AU Email:

Which of the following accommodations are you requesting?

Describe in more detail the accommodation that you are requesting:

Describe in more detail why you are requesting this accommodation:

Please understand that submitting this form does not guarantee that you will receive the above requested accommodation(s). We will contact you once our task force has had a chance to review your request. Please also note that you make be asked for further documentation.

For any questions about classroom accommodations, contact eschlauch@averett.edu, for questions about housing accommodations contact, HRL@averett.edu.

Contact Information