ADA Request Form - Coastal Education Services

ADA Request Form

Please complete the form below to make any ADA or other requests specific to the Professional Development Activity you plan/will attend.

- Please be specific so we may accommodate you as best as possible.
- We will communicate back with you within 72 hours of the request.
- If your need is for something sooner, we suggest calling or texting.
- It is important to give a personal email address as some business Firewalls are
too strong and do not allow our email responses to be delivered.
- A phone number will allow us to reach you if we can not reply using email.

To contact Coastal Education Services specifically for your ADA needs please complete this form or contact us using our other information provided.

* Indicates required field

Your Name *

First

Last

Conference and Date you are registering for. *

Primary Email *

Primary Phone number *

Request/Accommodation *

Submit

EMAIL ADDRESS

coastaleducationservices@yahoo.com

TELEPHONE/TEXT NUMBER

207-286-5631

MAILING ADDRESS

P.O. Box 3064
Kennebunkport, ME 04046