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ADA Reasonable Accommodation Request - Access to City Program, Service, Activity, or Facility (FORM 2008B, Revised 8/14/2017)

Steps

  1. 1. Introduction
  2. 2. Section A
  3. 3. Section B
  4. 4. Section C
  5. 5. Section D
  • Introduction

    1. Introduction

    2. Purpose

      This form is to be used by individuals seeking a reasonable accommodation with respect to accessing a City program, service, activity, or facility pursuant to the Americans with Disabilities Act (Title II) and/or Section 504 of the Rehabilitation Act of 1973. The City is dedicated to providing reasonable accommodation to all qualified individuals with disabilities using its facilities or participating in its programs, services, and activities.

    3. Instructions

      Please submit this request to one of the City officials listed at the bottom of page 2 of this form. If you need assistance completing this form, please contact one of these officials. Alternative means of submitting an accommodation request, such as by personal interview or telephone, may be made available upon request. A request for accommodation should be made as much in advance as practical; please contact the department offering the program, service, or activity should you have questions about how much advanced notice is required.

    4. Please return this form as follows:

      Accommodation requests related to the Murfreesboro Parks and Recreation Department’s programs, services, activities, and events should be submitted to:

      Angela Jackson
      Assistant Director, Murfreesboro Parks and Recreation Department
      697 Veterans Parkway
      Murfreesboro, TN 37128
      Phone: 615-890-5333
      Fax: 615-904-6507
      Email Angela Jackson

      All other accommodation requests should be submitted to:

      Robert Holtz
      Chief Building Official, Building and Codes Department
      111 West Vine Street
      Murfreesboro, TN 37130
      Phone: 615-893-3750
      Fax: 615-848-3248
      Email Robert Holtz