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ADA Reasonable Accommodation Request - City Employee or Job Applicant (FORM 2008A, Revised 8/14/2017)

Steps

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

    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:

      Pam Russell
      ADA Co-Coordinator and Human Resources Assistant Director
      City of Murfreesboro
      111 West Vine Street
      Murfreesboro, TN 37130
      Telephone: (615) 848-2553
      Facsimile: (615) 904-6506
      Email: prussell@murfreesborotn.gov