Online Housing Application

Questions

1.  

   My class standing at the end of this semester will be: (Select all that apply.)

   Incoming first year student

   Incoming transfer student

   Freshman

   Sophomore

   Junior

   Senior

   Other

   Additional Note or Comment
2.  

   Please choose the option that best describes your current status at Westmont. * (Selection is Required)

   This is the first time I am requesting housing accommodations at Westmont.

   I am only requesting a renewal of the same housing accommodations I had last year at Westmont.

   I am requesting different or additional housing accommodations at Westmont. Please describe your current accommodation in the space below. New documentation may be required.

   Additional Note or Comment
3. Describe the disability that is the basis for your accommodation request.
4. Please explain the barriers you experience (or anticipate experiencing) related to Campus housing.
5.  

   What accommodation(s) are you applying for? Provide specific details in the additional note of the comment section. (Select all that apply.)

   Single Room

   Double Room (rather than a triple room)

   Off Campus

   ADA-Equipped Room

   Access to Kitchen

   Meal Plan Modification (Please note: There are additional first steps with the DC.) Dietary Accommodations

   Parking Permit (Please note: There is limited availability due to Westmont's Conditional Use Permit.)

   Emotional Support Animal in Campus Housing (Please note: There are specific deadlines plus additional forms to complete.) Service and Support Animals

   Other

   Additional Note or Comment
6. Please explain how the accommodation(s) you are requesting will reduce symptoms or the barriers due to your condition.
7.  

   If this is the FIRST TIME you are requesting a housing accommodation, choose the best description(s) of documentation for this request. (Select any that apply.)

   N/A - I am only renewing my existing accommodation.

   I will have my provider complete the required Housing Accommodation Provider Form.

   I have the relevant documentation needed, and will upload it as part of this application process.

   I need to get relevant documentation from my provider. I will upload or email to ods@westmont.edu.

   Additional Note or Comment
8.  

   If you are RENEWING an existing housing accommodation, choose the best description(s) of documentation for this request. (Select any that apply.)

   N/A - I am making a request for the first time.

   My condition has NOT changed and ODS has specific the Accommodation Provider Form on file.

   My condition HAS changed and I will have my provider complete the required Housing Accommodation Provider Form.

   I have the relevant documentation needed, and will upload it as part of this application process.

   I need to get relevant documentation from my provider. I will upload or email to ods@westmont.edu.

   Additional Note or Comment
9.  

   May we contact your documentation provider for more information? * (Selection is Required)

   Yes (please list provider’s name, title, contact details in the notes section below)

   No

   Additional Note or Comment
10. Is there any other information that would be helpful for us to know?
11.  

    Are there academic accommodations you would like to request related to a disability, medical condition or mental health concern? * (Selection is Required)

    I do not need academic accommodations.

    I have already applied for accommodations.

    I am already receiving academic accommodations.

    Yes, I will follow up by completing a New ODS Student Application.

    Unsure at this time, but will contact an ODS staff member ods@westmont.edu.

    Additional Note or Comment