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Section I: Student Demographics
Tell us a little about yourself and provide your contact information
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Can we leave a message at this number *
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Check any that might apply to you:
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Section II: Nature of disability
Some students have more than one disability. Please check all those which might apply to you.
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The nature of my disability is: *
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Section III Documentation Upload
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Please check the circumstance that best describes you: *
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We send limited but crucial information to students periodically by email about deadlines, important events, etc.
Would you like to be notified of important deadlines, reminders and activities through the Glendon Accessibility Services Email Listserve?
Only Glendon or Keele Accessibility/Disability Services can send email to you via the ListServe. *
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Section IV Information About You As A "New" Student Registering with Accessibility Services
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When do you expect to start your studies at Glendon Campus? *
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I am coming from: *
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Level of study *
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Will you be living on campus?
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Do you require assistance getting around the campus?
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Do you require Attendant Care services?
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Section V Strengths, Challenges and Goals
We'd like to help build your strengths. Please tell us more about your goals, strengths and areas you'd still like to work on.
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Maximum of 500 characters allowed. Currently Entered: 0 characters.
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Section VI Career Goals
We want to get a sense of where you might be headed. Fill in this section to the best of your ability knowing that you might change course and direction while you are here.
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Section VII, Supports
Students need access to a variety of supports while they are students. This section will help us to determine what you have had in the past, what supports you might currently have in place and where we might be able to make suggestions for further support.
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Maximum of 500 characters allowed. Currently Entered: 0 characters.
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Are you currently or have you ever been on academic warning at York or another university? *
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What academic accommodations do you think you might require at York?
Please Note: Accommodations are highly individualized. Actual accommodations will be set with you at your initial meeting and will be based on the specific medical/psychological documentation you provide to us and the core essential requirements of a course. At no time can academic accommodations breech academic integrity.
Please check all those that apply: *
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Maximum of 500 characters allowed. Currently Entered: 0 characters.
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How prepared are you feeling with respect to starting courses at university? *
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Maximum of 500 characters allowed. Currently Entered: 0 characters.
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Maximum of 500 characters allowed. Currently Entered: 0 characters.
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Consent to Disclose/Discuss Academic Accommodations
There may be occasions when groups or individuals external to Accessibility Services, including Course Directors, TA's, staff in Alternate Exam & Test Scheduling and staff in Library Accessibility Services, may need to discuss your academic accommodations.
Alternate Exam & Test Scheduling is responsible for the scheduling and invigilation of accommodated tests and exams written by students registered with Accessibility Services. Alternate Exam & Test Scheduling is part of the department of Students Affairs.
Library Accessibility Services provides textbooks and other print materials to students registered with Accessibility Services in alternate formats (e.g. electronic). They also provide the door access code to room 134 (a work and study space in Scott Library, Keele Campus, designated only for students with disabilities).
There may be occasions when your course directors will want to discuss the disability-related rationale for your academic accommodations.
Your specific disability diagnosis will NOT be disclosed to any person outside of Accessibility Services (including those listed above) without further consent from you.
Please note: consents granted below can be rescinded at any time by contacting your Accessibility counsellor.
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I hereby give Accessibility Services consent to provide and discuss my test/exam accommodations with Alternate Exam & Test Scheduling. *
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I hereby give Accessibility Services consent to discuss my accommodations with Library Accessibility Services *
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I hereby give Accessibility Services consent to discuss my academic accommodations with course directors/TAs. *
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