MDUSD Request For Accommodations

1. First Name *This question is required.

2. Last Name *This question is required.

3. Work Site *This question is required.

4. Position *This question is required.

5. FTE (e.g. 1.0) *This question is required.

6. Work email *This question is required. This question requires a valid email address.

7. Cell Phone (with area code) - any format *This question is required.

The ADA prohibits employee disability-related inquiries unless they are job-related and consistent with business necessity.

Some of the below questions may or may not apply to your specific situation. Please answer each question as best as you can.