Phone Screening Accommodation Request

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Phone Screening Accommodation RequestBob Stratton2025-12-16T15:40:05-08:00

Disability Accommodation Request for Phone Screening

Clients that are unable to participate in a phone screening due to disablity can request accommodation.

Today's Date(Required)

Name(Required)

First Last

Date of Birth(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Enter Email Confirm Email

Prefered Contact Method(Required)

Mail

Phone

Preferred Language(Required)

Accommodation Requested(Required)

Deaf or Hard of Hearing

Speech Disability

Other Disability

State the specific accommodation you are seeking and give a brief reason for the request. You must describe why or how you are unable to access the phone eligibility screening process:(Required)

Title VI / ADA Statement

It is Opportunity Council policy to assure that no person shall, on the grounds of race, color, national origin, sex, age, or disability, as provided by Title VI of the Civil Rights Act of 1964, be excluded from participation in, be denied the benefits of, or be otherwise discriminated against under any of its federally funded programs and activities.

Opportunity Council complies with the Americans with Disabilities Act. We are an Equal Opportunity Employer. In accordance with Federal laws, U.S. Department of Agriculture (USDA) civil rights regulations and policies, and U.S. Department of the Treasury policy, Opportunity Council is prohibited from discriminating on the basis of race, color, national origin, sex, religious creed, disability, age, political beliefs, or reprisal or retaliation for prior civil rights activity.

This website is supported in part by Grant Number 2401WACOSR from the Office of Community Services within the Administration for Children and Families, a division of the U.S. Department of Health and Human Services. Neither the Administration for Children and Families nor any of its components operate, control, are responsible for, or necessarily endorse this website (including, without limitation, its content, technical infrastructure, and policies, and any services or tools provided). The opinions, findings, conclusions, and recommendations expressed are those of the author(s) and do not necessarily reflect the views of the Administration for Children and Families and the Office of Community Services.

For Telecommunication Relay Services, call 7-1-1 on your phone. For information or to request accommodation, please contact the Human Resources department.

Learn more about Opportunity Council and the Americans with Disabilities Act.

Contacting the U.S. Department of Treasury.

Contacting U.S. Department of Agriculture.