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New Housing/Meal Accommodation Application

Two easy steps to register
Thank you for contacting the Office of Disability Resources about your housing and/or dining services accommodation needs. Disability Resources and the Office of Housing Operations and Residence Life work closely together to ensure accommodations are appropriately implemented for students with disabilities living on campus. We welcome the opportunity to work with you to address your housing and/or dining services needs.

As you review your accommodation request, please remember that a housing contract must be completed to live on campus.

In order to initiate the housing/dining services accommodation request process, you (the student) must complete these steps:

1. Complete and submit this request.

2. Obtain documentation from a qualified health or other provider in support of the requested accommodation(s). Documentation must include the diagnosed disability, functional limitations, along with recommendations for accommodations.

3. Provide disability-related documentation to Disability Resources. If you have documentation at the time you fill out the request form, you can upload your documentation. Or, submit documentation by mail, fax, or email using the following contact information. *

Jacksonville State Universtiy
Attn: Office of Disability Resources
700 Pelham Road North
Houston Cole Library - Office 209
Jacksonville, AL 36265
Hours: Monday – Friday: 8 a.m. – 4:30 p.m.
P 256-782-8380(office)
F 256-782-8383 (fax)

* NOTE: Please refer to our student handbook for examples of what documentation you may need. If you are not sure or have questions on what to submit, please reach out to and we will be happy to answer any questions you may have.

Upon receiving both the completed online request and documentation,
Disability Resource staff will evaluate the request and schedule a time to review the request with you. Once approved, our office will email written notice to University Housing and/or Dining Services, and email a copy of the written notice to you via your JSU email address.

Requests will be evaluated in a timely manner within the context of current University policies, your needs, and available facilities. Space is limited in University Housing facilities, so early requests for housing accommodations are strongly encouraged.



Completing the request for Housing and/or Dining Services accommodation does NOT include requesting academic accommodations which is a separate process. If, at any time during your matriculation at the Jacksonville State University, you would like to request academic accommodations to address disability-related barriers in a classroom setting, please contact us to discuss the process or complete a request online. Our office can be reached by email to or phone at 256-782-8380.


Please be aware that the housing accommodations list which appears on the application is not exhaustive and other housing accommodations may be available.

Please contact Disability Resources if you have any questions or concerns.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Hint: Enter 9 alpha numeric characters.
  3. Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Contact Information
  1. Hint: Enter 10-digit number only.
  2. Hint: Enter 10-digit number only.
Local Address
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information


    Select the class standings that describe you (Check all that apply):
    Are you requesting accommodations for any of the following (check all that apply):
    How did you learn about Disability Resources? (Check all that apply). * (Selection is Required)
    By completing this application: * (Selection is Required)
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