City of Hampton Request for Accommodation

Request for Accommodation to Participate in a City of Hampton Meeting, Program, or Event
The City of Hampton is in compliance with the Americans with Disabilities Act of 1990. If you require an accommodation, such as a sign language interpreter or other auxiliary aid to participate in the meeting, reasonable accommodations can be made upon request.

To ensure that we have the appropriate personnel or equipment, we ask that you please submit your request at least five (5) days in advance of the meeting by submitting this form, calling 757-727-8311, or emailing ADAcoordinator@hampton.gov. Reasonable accommodation requests made less than five (5) days prior to the meeting will be addressed to the extent practicable.

Please note that the ADA does not require the City of Hampton to take any action that would fundamentally alter the nature of its programs or services, or impose an undue financial or administrative burden.
Date of Request

MonthDayYear
Date
Name

First NameLast Name
How should we contact you?
Please provide your contact information below:
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
If you chose US Postal Service, please provide your mailing address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If you chose email, please provide your email:
example@example.com
If you chose "other", please provide us with how to reach you below:

Request for Accommodation to Participate in a City of Hampton Meeting, Program, or Event

Please tell us about the city program, event, or meeting and your accommodation request.
Meeting, Program, or Event Date:

MonthDayYear
Date
Name of the Meeting, Program, or Event (example: Mayor's Book Club)
Meeting, Program, or Event Location:
If the location is not found in the dropdown menu, please add it here:
Provide your request for accommodation below (be specific as possible):

Request for Accommodation to Participate in a City of Hampton Meeting, Program, or Event