Program for Deaf Adults: Accommodation Services Request Form

Your request for accommodation services will be emailed to Program for Deaf Adults. You will receive an email copy of your request and be notified once accommodation services have been arranged. Please notify pda@lagcc.cuny.edu at least 48-hours in advance if you need to cancel services. If you have any questions or concerns, please contact: pda@lagcc.cuny.edu

Name(Required)

Additional Information

Please select the type of accommodation services you are requesting for the course/event: *(Required)

Is this a one-time or ongoing request for services?
(one-time: campus/class event, off-campus field trip, meeting with professor, etc. OR ongoing: weekly meetings etc.)

Start date of course/event
End date of course/event(Required)
Start Time requested for course/ event
:
End Time requested for course/ event
:

This field is for validation purposes and should be left unchanged.
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