Office of Student Accommodations
Request for Services

If you are a student with a disability and would like services to participate in the academic programs of Reynolds Community College, please fill out this form. It will automatically be forwarded to our office. No action will be taken on your behalf by the Office of Student Accommodations until you have identified yourself as a student needing services through this office. If you would like to speak with someone regarding your disability, you may contact one of the individuals list below.

* - Required field

*Name:
Address:
City: State: Zip Code:
Student ID#:(if known) *Daytime Phone:
*Email Address:
Curriculum: *Term of Entry:
 
*At which campus will you be attending classes?

    

CAMPUS CONTACTS

Counselor
College-wide
Office: 804.523.5628    Fax: 804.371.3527
Center for the Deaf - 804.523.5290 via the 711 VA Relay Service

Susan Roach, Specialist   Althea Brooks, Specialist
Almaz Getachew, Counselor
Parham Road/Goochland Campus   Downtown Campus
Office: 804.523.5290   Office: 804.523.5628
Fax: 804.371.3527   Fax: 804.371.3527

An Affirmative Action/Equal Opportunity Institution - Deaf and Hearing Impaired - use VA Relay 711 Service

JSR Form 75-3001   Revised 3/2016