Office of Student Accessibility Registration

Office of Student Accessibility Registration
Name:

First NameLast Name
Student ID number:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area CodePhone Number
Type of Accommodation:

Other
Are you a returning student?
Term applying for:
Year:
Are these changes to already existing paperwork?
Please describe any specific accommodation you may request that are not outlined in your supporting documentation:
Additional comments:
Attach documentation (If multiple files, please ZIP and upload)

Browse Files

Cancelof
Email the Office of Student Accessibility Registration or call 859-344-3541 if you have additional questions.
Should be Empty: