What was the employer's response to your request for an accommodation? INSTRUCTIONS: Please print or type all information.The application must be filled out accurately and completely. INSTRUCTIONS: The application must be filled out accurately and completely. All statements are subject to investigation. Specify the position for which you are applying. (Note: A separate application must be submitted for each vacancy. A charge of discrimination can be completed through our online system after you submit an online inquiry and we interview you. ADA Title I provides protection from disability-based discrimination in all aspects of employment. ➢ Preventing Employment Discrimination. (PED).