Online Student Application

Welcome to the office of Student Access Services!
We are here to help you request appropriate disabilities accommodations at Ringling College of Art & Design.
Please fill in the requested information below.
Please include your Ringling ID and email.

Personal Information

Start Term *:
Note: Select when you would like to start your services.
Expected Graduation Term:
Note: Select when you plan to graduate.
First Name *:
Last Name *:
Middle Name:
Optional: Preferred Name:
Ringling ID *:
Birth Date:
Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Pronouns:

Contact Information

Primary Phone Number:
Hint: Enter 10-digit number only.
Secondary Phone Number:
Hint: Enter 10-digit number only.
Email Address *:

Local Address

Address *:
City *:
State *:
Zipcode *:
Hint: Enter zipcode as 97331 or 97331-0000.

Permanent Address

Same as Local Address

Address:
City:
State:
Zipcode:
Hint: Enter zipcode as 97331 or 97331-0000.

Additional Information

Seeking Degree:
Major:

Affiliation(s)

International

Non-traditional Student

Veteran
Additional Note:

Questions

Primary Disability
Additional Diagnosis/Disability
What type of documentation will you be submitting?

Individualized Education Plan (IEP) / 504 Plan

Psycho-social Educational Assessment

Clinical Narrative Summary

Specialist Treatment Plan/Requirements/Recommendations/Report

Additional Note or Comment
What accommodations have you previously used?
What academic accommodations would you like to inquire about?
I understand that this intake form does not establish accommodations and that a formal agreement is required before reasonable accommodations are put into place * (Selection is Required)

Yes

Additional Note or Comment

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