TESU Academic Accommodation(s) Request

You will have as much time as you need to complete this form. However, if there is inactivity on the form for a period of time, you run the risk that your information will be lost and you have to start over.

If you have questions prior to filling out the form please reach out to ADA@tesu.edu.
* indicates a required field

Student Information

Please enter your information
Preferred Pronouns

If you do not yet have a TESU Student ID, use your Legal Last Name and Last 4 digits of SSN. (Example: If your name is Thomas Edison and SSN is 123-456-789; your Student ID would be 'Edison6789'.)

Please enter the official email address that you are using for all university communications.

If no mobile number, then number at which you can be reached at all times
Do we have permission to send you a text message at this number? Required
I am also:Required

Consent to Release/Receive Information

For this section, check the parties you authorize the Office of Student Accessibility Services at Thomas Edison State University to obtain or to release information pertinent to receiving academic accommodations and/or services.

Parent/Legal GuardianRequired
Spouse/Family MemberRequired
Diagnostician who diagnosed the disabilityRequired
Licensed Health Care ProfessionalRequired

Specific Accommodation Information

I am requesting accommodations related to a temporary short-term injury and/or illness.Required
I am requesting accommodations for broken limbs, concussion, etc.
I am requesting pregnancy or postpartum or parent/parental responsibilities of a newborn accommodations.Required
I am requesting accommodations under NJSA 18A: 3B-74.
Identify the Term for which you are requesting accommodation(s).Required

Note: Academic Accommodation(s) must be requested prior to the start of the Term.

Documentation Requirements

Documentation Upload

Please refer to the information above regarding what type of documentation you are required to provide.

Once a student's documentation and verification have been received, reviewed, and approved, they will receive an Approved Academic Accommodations letter.  All students approved for academic accommodations are required to complete a Term Accommodations Request within the first week of every term in which they are asking to have accommodations activated. Please refer to "Completing the Term Accommodations Request" as found on the Resources page.

Students who are unable to upload files, can submit disability documentation/verification via secured fax to 609-337-4731 or by mailing to:

ADA Coordinator
Office of Student Accessibility Services
Thomas Edison State University
101 W. State Street
Trenton, NJ 08608

Office / Fax / Text: (609) 337-4731

Note: Students are advised that mail is routed through and opened by the University’s mail service, who have all signed a confidentiality agreement.