Accessibility Services Office - Student Intake Form

Student Information

To receive accommodations through the Accessibility Services, students must complete this form and are required to submit documentation. Please allow one week for the request to be processed.

If additional information is needed, we will email you. Please continue to check your WCC email regarding the next steps in the accommodations process.

Note: if you have not yet applied to Westchester Community College, please do so before filling out the Accessibility Services Intake Form. You can find more information on applying to the college by clicking HERE.

Please contact accessibility.services@sunywcc.edu with any questions. If you would like to learn more about Accessibility Services, please visit our webpage.

First Name

Last Name

Middle Name

Preferred Pronoun(s):

WCC Student ID (9 digit number)

Example: 000123456

WCC Email

Please use your SUNY WCC email address. Example: JSAMP55555@my.sunywcc.edu

Phone Number

Are you currently registered for classes at SUNY WCC?

Please choose semester when you will begin classes:

Only choose 1

Documentation

Upload supporting document(s)

In order to receive accommodations through Accessibility Services, students must complete this form and are required to submit documentation.

Documentation Guidelines

· Documentation must be uploaded with this form

· Please submit your most recent IEP, or 504 plan and Psychological Evaluation

· If you did not have a high school plan, you may submit a note from your healthcare provider.

· Documentation should:

· be on official letterhead stationery

· signed by the treating doctor (cannot be electronically signed)

· include the current diagnosis

· include the dates of treatment

· Provide recommendations for appropriate accommodations

Please contact accessibility.services@sunywcc.edu with any questions.

Specific Accommodation Information

Confidentiality Acknowledgement

Accessibility Services Office - Student Intake Form

Student Information

Documentation

Specific Accommodation Information

Document Information