Candidate Accommodations Request Form

Please fill out and submit the form below to request accommodations for participating in the recruitment process

Candidate Accommodations Request Form

Full Name(Required)

Email Address(Required)

Phone Number(Required)

Position Applied For(Required)

Date of Application(Required)

Residential State: (used to request accommodations assistance from state programs)(Required)

Do you require a reasonable accommodation to participate in the recruitment process?(Required)

Yes

If yes, please describe the accommodation you are requesting. Examples: ASL interpreter, wheelchair-accessible interview location, extended time for assessments, screen reader-compatible materials.

Preferred method of contact for follow-up:(Required)

Phone

Preferred interview format:

In-person

Virtual

No preference

If virtual, do you require any specific technology or setup? Example: Captioning, screen reader compatibility, alternative platforms.

The information you provide will be kept confidential and used solely to facilitate reasonable accommodations in accordance with applicable laws and company policy. I acknowledge and consent to the use of this information for accommodation purposes.(Required)

I agree

Signature (type your full name)(Required)

Date of submission(Required)

Please fill out and submit the form below to request accommodations for participating in the recruitment process

Candidate Accommodations Request Form

Atlanta Headquarters

National Capital Region Headquarters

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