Reasonable Accommodation Request Form

Reasonable Accommodation Request Form

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, physical or mental disability, sexual orientation, gender identity, genetic information, military service, pregnancy or pregnancy-related condition, or because of marital, parental, or veteran status. We are a VEVRAA Federal Contractor.

Directions:

Please complete the form below and we will connect you with one of our Equal Opportunity Office specialists to confidentially discuss your request for reasonable accommodation(s).

For more information, please read the US EEOC's Job Applicant and the ADA webpage here.

If you require further assistance, please contact us at talentandculture@wbur.org.

About You:

Your Full Name:*

Name Pronunciation:

Please to the best of you ability provide the phonetic spelling of your name. Need help? Check out PronounceNames.com

Your Preferred Name / Nickname:

(Optional) Pronouns:

i.e.: she/her, he/him, they/them, she/they, ae/aer

Contact Information:

Your Email Address:*

Your Phone Number:

Preferred Method of Communication:*

Select all that apply.

Select or enter value

Reasonable Accommodation Request:

Do you need to request reasonable accommodation(s) to apply to any of our open positions?*

Select or enter value

Do you need to request reasonable accommodation(s) to interview for any of our open positions?*

Select or enter value

Send me a copy of my responses

Privacy Notice|Report Abuse