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ADA Reasonable Accommodation Request - City Employee or Job Applicant (FORM 2008A, 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. This form is to be used by City employees and job applicants seeking a reasonable accommodation relating to their employment or application for employment pursuant to the Americans with Disabilities Act (Title I) and/or Section 504 of the Rehabilitation Act of 1973. The City is committed to equal opportunity in all aspects of employment for qualified disabled individuals. Information regarding the City’s ADA policy is also available on the City's website.
    3. If you have questions or need assistance completing this form, please contact:

      Randolph Wilkerson

      ADA Co-Coordinator and Employee Services Director

      City of Murfreesboro

      111 West Vine Street

      Murfreesboro, TN 37130

      Telephone: (615) 848-2553

      Facsimile: (615) 904-6506

      Email: rwilkerson@murfreesborotn.gov