Request for Reasonable Accommodation or Modification (Online)

The City of Cedarburg is committed to compliance with the Americans with Disabilities Act (ADA) in all aspects of providing equal access to all city-sponsored programs and events and does not discriminate on the basis of disability in the city’s services, programs or activities. This form may be used by citizens to request a reasonable modification to the accessibility of a city program, service or facility. Please submit this form no later than 72 hours before the event for which an accessibility modification is needed, so that we have time to properly honor your request.

Your Address
Please describe the material and requested format type. If your request is for materials printed in braille, please submit this form at least one week in advance.
Please describe the nature of your request.