Americans with Disabilities Act Accommodations Request We will provide reasonable accommodations so that a person with a disability can benefit from the goods and services available at Three Rivers Market in accord with the Americans with Disabilities Act. Accommodations are not available to individuals without disabilities, as they are not protected under the Americans with Disabilities Act. OK Question Title Do you have a disability that requires a reasonable accommodation so you can benefit from the goods and services available at Three Rivers Market in accord with the Americans with Disabilities Act? Yes No OK Question Title What accommodations would you like to request? OK Question Title Are you a member of the food co-op? Yes No OK Question Title If you are a member of the food co-op, what are the last 5 digits of your member number? OK Question Title What is your first name? OK Question Title What is your last name? OK Question Title What is your email address? OK Thank you! We will be in touch soon. OK DONE