Public Accommodation Request

* indicates a required field

Student Information

If you are already registered with the DRC and would like to request additional accommodations, please login to your Accommodation Portal to submit a Supplementary Request. Once in your portal, select "Accommodations" --> "Supplemental" --> "Add New" and fill out the form. This will notify your Access Specialist. Please contact your Access Specialist or the DRC Front Desk (drc@calpoly.edu or (805) 756-1395).

First Name

Last Name

Preferred Name

Pronouns

* Please use your Cal Poly email address (if available) for improved communication. * If you are not using a Cal Poly approved E-Mail address, be sure to check your 'junk/spam' folders for missing communication.

Personal Email

If you entered your Cal Poly email above, please enter a different, personal email address if you have one. If you entered a personal email address above, please enter your personal address again.

Primary Phone Number

Current Academic Level

Which term were you admitted to Cal Poly?

Affiliations/Identity

Specific Accommodation Information

Primary Disability Type

Additional Disabilities

Functional Limitations

Other Disability or Note

In what areas are you seeking DRC Services (check all that apply)

Are you seeking services for temporary or permanent disabilities?

Please describe the challenges or access needs that led you to request services?

List previous accommodations and/or resources you’ve received or used in the past (if applicable)

I am comfortable advocating for my disability-related needs

Voter registration Status

How did you hear about the DRC

Upload supporting document(s)