REQUEST FOR ACCOMMODATION
IN HOUSING

Student Name:                                                                    Date:                               

Home Address:                                                                                                            

Phone Number: (     )                             E-mail Address:                                            

SPECIFIC REQUEST:

REASON SUPPORTING REQUEST:

A)  Please provide an explanation of how the accommodation request relates to the condition.

B) Indicate the level of need for the requested housing accommodation and the consequences of not receiving it. (1-10 scale with 10 being the greatest need)

Please attach additional documentation from an appropriate physician, psychologist, physical therapist, audiologist, social worker or other appropriate licensed professional stating the diagnosis and reason for recommending this specific housing request.  Please have them respond to questions A) and B) in their letter of support.

OFFICE USE ONLY

Application approved                                    Application denied                           

Rational for decision:

Associate Dean of Students/ Director of Residence Life                                        Date

Request for Accommodation in Housing

Housing assignments and the residential learning environment are integral parts of the University of Evansville college experience.  We evaluate all requests for need-based housing accommodation carefully. Our evaluation is based on 1) the severity of condition, 2) the timing of the request and 3) feasibility and availability.

To evaluate accommodation requests based on medical, psychological or disability related conditions accurately and equitably, the University of Evansville will need documentation which consists of a completed Request for Accommodation in Housing and an evaluation from a relevant physician, psychologist, physical therapist, audiologist, social worker or other appropriate licensed professional that describes the current impact of the condition in relation to the request.  Documentation supporting a request will be reviewed by the Associate Dean of Students/Director of Residence Life with consultation with the Disability Services Coordinator and all documentation will be held by those offices.  All information is considered confidential.

Single Room Requests   It should be noted that living within the community, and learning to share space and be considerate of others is part of the Evansville residential learning experience.  Requests for single rooms as an accommodation based solely on a desire to have a “quiet, undisturbed place to study” are generally not granted.  The University provides quiet study areas in the residence halls and in the library.

First semester Freshmen are generally not assigned single rooms.  Students who make requests for single rooms solely on a desire to have a “quiet, undisturbed place to study” may be given priority on a single room wait list through the Request for Accommodation in Housing process.  Upper-class students and second semester freshmen who prefer single rooms may obtain private rooms when space permits through placement on the single room wait list.  All students who attain a single room assignment will be held responsible for paying the differential between single/double room fees.