Accessibility Request Form

Due to campus construction, many changes have been made regarding parking arrangements. However, HCC remains committed to providing accessible parking for students requiring handicapped spaces. If you are a student with a disability and have concerns about getting to your class(es), please complete the following form.

Personal Information

First name:

Last name:

Student ID#:

eMail address:

Phone:

Additional Information

Are you a student using a wheelchair:

No

Yes

If you are submitting this request and do not currently have a handicapped plate or hangtag from the Department of Motor Vehicles (MVA), please state your reason for completing this request in the box below:

(You will need to be prepared to submit medical documentation along with this request.)

Courses/times that cause you concern

Course 1

Course name:

Days/Times:

Building/Room:

Course 2

Course name:

Days/Times:

Building/Room:

Course 3

Course name:

Days/Time:

Building/Room: