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Commencement Accessibility Request Form

Home » Commencement » Commencement Accessibility Request Form

Please complete the form by April 18, 2023 for each individual requesting accessibility related services.
Name of Student Graduating*
First Last
Name of person requiring accommodation*
First Last
Indicate your position as an attendee*
Name of Person to contact regarding this accommodation
Contact Name*
First Last
Email*
Day Phone*
Evening Phone
Information on Accommodations
Nature of Accessibility Need (check all that apply)*
- Sight
- Hearing
- Mobility
- Illness
- Other
Other, please explain:*
Request for Accommodations (check all that apply)*
- Sign Language interpreter
- Listening Devices
- Accessible Reserved Seating
- Other
Other request for accommodations, please describe:*
Accessible Reserved Seating, # of seats requested:*
Indicate mobility devices that you will be bringing with you (check all that apply)
- Powered Wheelchair
- Wheelchair
- Cane
- Crutches
- Walker
- Service Dog
- Other
Other mobility devices, please describe:*
For those needing to rent medical equipment such as wheelchairs, a local vendor is available: County Square Pharmacy 508-222-7620
Please provide any other information that will be helpful in accommodating your needs:
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Wheaton College - Massachusetts

26 E. Main Street
Norton, MA 02766
508-286-8200

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