Moody Bible Institute
 
REGISTRATION/SELF-IDENTIFICATION FORM
STUDENTS WITH DISABILITIES
 
It is the goal of Moody Bible Institute to ensure all college services, activities, facilities, and privileges are accessible to qualifed persons with disabilities.  Appropriate accommodations will be made on an individualized basis.  It is the responsibility of persons with disabilities, however, to seek available services and make their needs known to the Assistant Dean, Student Resource Center (SRC).
 
If you believe you are an individual with a disability who may require accommodations from Moody Bible Institute, please complete this form and use the submit button below.  The information provided will only be used by the Assistant Dean to aid in determining accommodation needs.  You may also make an appointment with the link at the bottom of the form.
Class status? *
Campus location? *
Live on campus? *
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Indicate your area of disability: *
 
For futher information, contact:  
Gayla Gates
Assistant Dean Student Resource Center
820 N. LaSalle Blvd.
Chicago, IL   60610-3284
Phone: (312)-329-2177 Fax (312) 329-4479