Temporary Disabled Permit Registration
Please complete and submit the following information to obtain a Temporary Disabled Permit. Temporary Disabled Permits are available only to those individuals with a verified need and who have applied for, but who have not yet received a government issued disability placard. Upon submission of this form, please provide the Office of Accessible Education Services, located on the second floor of Dar Hall, Room 214, with a signed note from a medical provider supporting the request for a Temporary Disabled Permit, as well as a copy of the application submitted to obtain a government issued disability placard. Temporary Disabled Permits are only valid for one month from the date of issuance.
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    By signing/checking below, I certify that the above information is correct, that I understand the Temporary Disability Permit is valid for only one month from the date of issuance, and that I will need to provide the Office of Accessible Education Services a signed note from a medical provider supporting the request for a Temporary Disabled Permit and a copy of the application submitted to obtain a government issued disability placard before I will be able to be approved for a Temporary Disabled Permit.
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