Skip Navigation
HOME
A-Z INDEX
DIRECTORIES
ASK "THE GOV"
AP ONESTOP
Search APSU:
Our Campuses
Admissions
Academics
Athletics
Campus Life
Events
Giving to APSU
News
Office of Disability Services
The Move Towards Independence
Accommodation Guidance
Eligibility
ODS Values
Services & Technology
ODS Staff
Student Assistants
Volunteer with ODS
Faculty
Announcements & Events
Scholarships
The Advocate
Forms
Accessible & Universal Design
Contact Us
Office of Disability Services
Morgan University Ctr, Room 114
P.O. Box 4578
Clarksville, TN 37044
(931) 221-6230
TTY: (931) 221-6278
ods@apsu.edu
Home
»
Disability
»
Forms
»
At
»
Assistive Technology (AT) Tech Support Request Form
Assistive Technology (AT) Tech Support Request Form
Date of Request:
*
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2011
2012
2013
2014
2015
Client's Name:
*
Client's Phone Number:
*
Format: (xxx) xxx-xxxx
Client's Email:
*
Building and Room Number:
Lab/Loan Computer Number:
Name of Assistive Technology :
SUMMARY of Problem -- clear description of the problem the client is having:
*
^ Back to Top