Academic Accommodations Request Form

Galvanize is committed to providing students with disabilities equal access and participation in our programs as specified under applicable federal law. The process for granting accommodations to students with disabilities is managed by the Galvanize Accommodations Team (accommodations@galvanize.com).

It is the student's responsibility to read and understand the Academic Accommodations Policy prior to completing and submitting this form.

Requests that are missing information are considered incomplete and cannot be reviewed until all information and documentation is received. Similarly, requests sent by email or other channels to the Accommodations Team without a corresponding form submission will be considered incomplete and cannot be reviewed.

Supporting documentation is required in order for your request to be considered complete. Students with readily observable disabilities may not be required to submit documentation. Disabilities that can only be diagnosed through testing (e.g. learning disabilities) require documentation.

Documentation must be from a medical professional and should at minimum include the information listed below. Documentation that does not include the below information will be reviewed on a case-by-case basis to determine if sufficient information is available to appropriately evaluate the request and determine accommodations:

Identification of diagnosed disability
Description of functional limitations as a result of the disability
Recommendations regarding accommodations that will assist with functional limitations of the disability(ies)