Public Accommodation Request

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Self-Disclosure Disability Form

Providing this information is voluntary. Pennsylvania College of Technology provides appropriate academic accommodations to students with documented disabilities who elect to disclose their special needs.

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Please use your college issued email address

Specific Disability/Accommodation Information

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To select multiple disabilities, please use the "select" dropdown menu again.
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Please use this section of the form to upload documentation of your disability. If you have multiple files, please click "Add item" to upload additional documentation. If you wish, you can also mail, fax, or hand deliver your documentation to the Disability Services Office. Fax: 570-327-4501. Mail: Pennsylvania College of Technology DIF74 One College Ave Williamsport, PA 17701
Are you a WDCE Participant?(Required) *
By indicating "yes", you are registered to take non-credit course (s) and/or training/certification options through Workforce Development and Continuing Education (WDCE).