Accommodation Request

The City of Mukilteo welcomes an accommodation request for a translator, barrier removal, etc., or documents/materials in alternate formats in any letter, email, newsletter or website used to announce, invite or promote a City program, service or activity. If this information is not provided, please contact the City's ADA Coordinator to make your request. Please make requests for accommodation at meetings or events as soon as possible or no later than 48 hours prior to the scheduled event. Requests for accommodation at a City meeting/event or materials in alternate formats should include:

The requestor's name, address, email and telephone number (if any)
A description and location of the program, service or activity where the accommodation is being requested
A brief description of why the accommodation is needed
For materials in alternate formats: All of the above and what type of format is desired

The City ADA Coordinator (Katie Casey, 425-263-8003) or the responsible City Department will respond to the request in advance of a scheduled meeting or event. If the response does not satisfactorily resolve the issue, the requestor may file a formal grievance with the City. All requests for accommodations and alternate formats will be kept on file for at least three years.

Online Accommodation Request Form

Use this online form to request an accommodation from the City of Mukilteo.
Today's Date*
Today's Date
First Name of Person Needing Accommodation*
Last Name*
Address of Person Needing Accommodation*
City*
State*
Zip Code*
Phone*
Email Address
If there is no email address, you may leave this field blank.
Description of the program, service or activity that an accommodation is being requested*
Date of Activity or Program
Date of Activity or Program
Location of the program, service or activity*
If none, type "N/A".
Is this a request for an alternate format for a City document such as the Civil Rights and Title VI Complaint Procedure or similar material?*
1. Yes
2. No
Please provide a description of the accommodation or alternate format or similar material being requested and why it is needed.*
First Name
Please provide your name if different from the person needing an accommodation.
Last Name
Please provide your phone number so we may contact you
Please provide your email address so we may contact you if we have questions about this request

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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Accommodation Request

Online Accommodation Request Form

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