The NYCHA 015.208 form represents a crucial document within the New York City Housing Authority's framework, designed to facilitate the process of requesting reasonable accommodations for qualified job applicants and employees with disabilities. This initiative underscores NYCHA's commitment to inclusivity and the equal treatment of all its workforce members, ensuring they can perform essential job functions or enjoy equal benefits and privileges of employment. Recognizing the diversity of its applicants and employees, the form lays out a structured process for requesting accommodations that may be necessary due to a disability unless such accommodations present an undue hardship on the operation of the Housing Authority. The form is segmented into clearly defined sections for job applicants, current employees, supervisors, and directors, each with specific instructions to streamline the accommodation request process. This thorough approach not only aids in maintaining organizational efficiency but also supports NYCHA's adherence to its Reasonable Accommodation Policy and Procedure for Employees and Job Applicants. By assisting applicants and employees through the Human Resources Department and designated coordinators, NYCHA reinforces its dedication to an accessible, supportive work environment while also ensuring confidentiality and due consideration of each request.
| Question | Answer |
|---|---|
| Form Name | Nycha 015 208 Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | gvbhfghgfh, disabilities, nycha long island city, what is a po box 19196 |
NYCHA 015.208 (REV. 9/04) & REVERSE
Reasonable Accommodation Request
NEW YORK CITY HOUSING AUTHORITY
Human Resources Department
Date Received:
(To be completed by ERAC)
The New York City Housing Authority (NYCHA) will make reasonable accommodations for qualified job applicants and employees with disabilities to enable them to perform the essential functions of their jobs, or to enjoy the equal benefits and privileges of employment and the employment process, unless providing such an accommodation would be unduly costly, extensive, substantial or disruptive, or would fundamentally alter the nature of operation of the Housing Authority or any of its programs. This form shall be made available to, and used by, all job applicants and employees requesting a reasonable accommodation in accordance with NYCHA’s
Reasonable Accommodation Policy and Procedure for Employees and Job Applicants.
INSTRUCTIONS: Where necessary or requested, NYCHA supervisory staff, the Human Resources Placement and Certification Coordinator (Interviewer), and/or the Employee Reasonable Accommodation Coordinator (ERAC) shall assist applicants or employees in completing this form.
Job applicants - Complete Sections I and II and submit this form to the staff supervising the application process. Current NYCHA employees - Complete Sections I and III and submit this form to your immediate supervisor. Interviewers/Supervisors - Complete Section IV, and return one copy of the completed form to the job applicant or employee requesting the accommodation. In a separate confidential file, retain a copy of completed form, and send a copy to the ERAC (Human Resources Department, 90 Church Street, 5th Floor, New York, NY 10007). The original form is to be sent to the
Department Director/HR Director - Complete Section V, as appropriate.
Section I
Both job applicants and current employees should complete this section.
Name
Address
Phone
Accommodation Requested (attach additional sheets and any supporting medical documentation, as appropriate)
Section II
To be completed by job applicants only.
Position/title applied for gvbhfghgfh
Department/Development (if known)
Job Vacancy Notice Number (if known)
Date of Examination/Interview
OVER
NYCHA 015.208 (REV. 9/04) - REVERSE
Section III
To be completed by NYCHA employees only (even if you are currently on leave).
Position/Title
Department/Development
Supervisor
Section IV
This section should be completed by the Interviewer of the job applicant, or by the supervisor of the em- ployee requesting a reasonable accommodation.
Name and Title
Department/Development
Phone
Date Request Received
Signature
Section V
In the event a reasonable accommodation is granted at the outset of the process, this section should also be completed before sending a copy to the ERAC.
If the request involves a personnel action that requires the Human Resources Director’s approval, describe the recommended reasonable accommodation and check RECOMMENDED.
Disposition of the Request for Reasonable Accommodation:
GRANTED
RECOMMENDED
DENIED Date
If a reasonable accommodation has been GRANTED / RECOMMENDED, describe the accommodation:
Name and Title
Department
Signature |
|
Date |
An employee may file a written appeal of the Department Director’s decision with the ERAC
within 10 days of receipt of the decision.