Public Accommodation Request

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Confidentiality Statement

All information provided on this request form will be kept confidential to the extent possible and will be visible only to those with a need to know and those required to consider/process this request.

NGIS

ATTENTION NGIS EMPLOYEES: Please contact your cognizant HR Business Partner to request an accommodation prior to January 1, 2020.

Proxy Information

Are you submitting this request on behalf of another person?(Required) *

Requestor Information

Please enter requestor information

Current NG Employee?(Required) *
New Hire?(Required) *
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Accommodation Specific Information

What is the requested accommodation(s)?(Required) *

Requestor Accommodation

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