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Online Application

Important Messages

Welcome to the Human Resources online employee application for ADA accommodation requests.

Under state and federal law, when an employee makes a request for an accommodation, the employer is required to enter into an interactive process to determine whether an accommodation can be provided which is effective for the employee and does not impose an undue hardship upon the employer.

By completing this form you are giving consent for Human Resources to share pertinent information regarding your accommodations with Lane Community College Management and Staff as needed to facilitate the interactive accommodation process. Sharing information is intended to assist others in understanding and supporting your request(s) for accommodations, health and safety, and to create effective strategies for the provision of accommodations and employment success. This consent can be revoked at any time by contacting Human Resources.

Medical information may be necessary as part of the interactive process. When an individual qualifies for reasonable accommodation, the employer is free to choose among effective accommodations, and may choose one that is less expensive or easier to provide.

It is a policy of the state Board of Education and a priority of the Oregon Department of Education that there will be no discrimination and harassment on the grounds of race, color, sex, sexual orientation, marital status, religion, national origin, age, or disability in any educational programs, activities or employment. Inquiries may be directed to the Associate Vice President of Labor Relations and Human Resources, (541) 463-5586.

Employees who wish to verbally request an accommodation or are in need of assistance in completing this form may contact Heidi Morales, ADA Accommodations Coordinator, at or (541) 463-5592.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Hint: Enter L#
Contact Information
  1. Hint: Enter 10-digit number only.
  2. Hint: Enter 10-digit number only.


  1. Employee Group *
  2. I give HR permission to call and leave a detailed message at the contact number I've provided: *
  3. I give HR permission to include detailed information in email: *
  4. Is there any other information that would help us evaluate your request? *

Terms and Conditions

I authorize the release of information regarding my disability to Lane Community College Management and Staff as deemed necessary by Human Resources to facilitate this request for accommodation.

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