Maricopa, AZ · Pinal County
Request for Accommodation Form
Members of the public use this form to request a reasonable accommodation or modification to a City of Maricopa program, service, or activity.
What this form is
This form lets members of the public request a reasonable accommodation or modification to a city program, service, or activity. The city asks requestors to submit it to the appropriate department and provide their contact information, request type and location, the accommodation needed, why it is necessary, and the date it should be implemented.
Who needs it
Members of the public who need an accommodation or modification to a City of Maricopa program, service, or activity should complete this form.
How to submit it
Submit the completed form by mail or email to the appropriate department. The form lists City Hall at 39700 W Civic Center Plaza, Maricopa, AZ 85138, and asks requestors to contact the appropriate department for assistance.
About notarization
This document is signed and dated without a notary; it does not identify any attachment or related step that must be notarized or sworn.
How to submit this form
- 1
Download The Form
Download the Request for Accommodation Form.
- 2
Complete The Form
Provide your contact details, request type and location, requested accommodation, reason, and implementation date.
- 3
Sign And Date
Sign and date the completed form.
- 4
Submit To The City
Mail or email the form to the appropriate department.
Frequently asked questions
- Do I need a notary for the Request for Accommodation Form?
- No. The form asks you to sign and date it, but does not require a notary or identify any attachment or related step that must be notarized or sworn.
- Who can use this form?
- Members of the public who need a reasonable accommodation or modification to a City of Maricopa program, service, or activity can submit this form.
- What information does the form ask for?
- It asks for your name, request date, phone, email, whether you are a parent or participant, the request type and location, the accommodation needed, why it is necessary, and the date needed.
- How do I submit the Request for Accommodation Form?
- Submit the completed form by mail or email to the appropriate department. The form lists City Hall's mailing address and advises contacting the appropriate department for information or assistance.