Request for Accommodation

2. Request for Accommodation
   Any person who has a qualifying disability as defined by the Americans with Disabilities Act shall not be excluded from participation at City of Delafield meetings. Please advise the City Clerk 5 days prior to the meeting for special accommodations.

   Any person who has a qualifying disability as defined by the Americans with Disabilities Act shall not be excluded from participation at City of Delafield meetings. Please advise the City Clerk 5 days prior to the meeting for special accommodations.

4. First Name

5. Last Name

7. Which meeting will you attend?*

9. Required Accommodations*

   Max 1200 characters

11. Contact Phone or Email

    If you would like us to contact you to discuss your accommodations, please include a phone number or email address.

Leave This Blank:


13. Submit

* indicates a required field