Special Needs

In order to accommodate SCMS students who have special dietary, medical, or physical needs or concerns, please fill in the form below so that the proper arrangements may be made.

Special needs examples:

  • Dietary (vegetarian, diabetic, low sodium, does not eat red meat)
  • Physical (on special medication, crutches, wheel chair)
  • Other (anything else SCMS administration should be aware of in case of an emergency)
Please indicate:




First Name 
Last Name 
CU or Organization Name 
Daytime Phone  
Email 
Dietary 
Physical 
Other 
Important, to best serve you, this form needs to be completed no later than Friday, May 31. If you have any questions, contact Lori Schirpke-Jordan at lschirpke-jordan@scms.coop, 1-800-442-5762 Ext. 6639 or 469-385-6639.
 
 
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