Holloway Hall


Registration for disabled seating at Salisbury University’s Commencement

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Disabled Seating Request Form
M M Name:
*Graduating Student’s First Name: 
*Graduating Student’s Last Name: 
*Graduation Ceremony:  
* Contact First Name:  
* Contact Last Name:  
*Phone number:  () - -
*Email address:  
*Total number of guests in party:  
*Number of disabled guests:  
*Needs for the disabled guest:
Can climb no more than 1-2 steps
Can walk only short distance
Vision impaired
Hearing impaired
Requires the use of a Service Animal
Other (specify in box below):

 Challenge Test: Enter the sum of forty-five + 3: