PDF
…ID:
Employee Phone:
Supervisor Name:
Supervisor Phone:
Department:
Date:
Do you have a qualifying disability that substantially limits one or more of the major life activities or functions? Major
life activities may include, but not limited to: Lifting, sleeping, concentrating, breathing, working, eating, walking,
standing, reaching, thinking,…
https://www.wichita.edu/services/humanresources/Total_Rewards/docs/Employee_Request_for_Workplace_Accommodations.pdf