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Online Student Application

Two easy steps to register
Welcome to the Access Services registration process. Please fill in the form as completely as possible.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  7. Hint: Enter 9 alpha numeric characters.
  8. Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Contact Information
  1. Hint: Enter 10-digit number only.
  2. Hint: Enter 10-digit number only.
Local Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  1. Affiliation(s)
  2. Campus Location(s)

Questions

  1.  
    I am: * (Selection is Required)
  2.  
    I am requesting accommodations for:
  5.  
    Please select the type of documentation you have:
  6.  
    Did you have an IEP or 504 plan in high school? * (Selection is Required)
Access Services will note our connection with you in the Customer Relationship Management System at Western Technical College. If you would like to revoke this connection, please contact us at AccessServices@westerntc.edu.

Western has a wonderful Counseling and Case Management department available as a resource for students. If you list any psychological disability, someone from that department will be reaching out.

Submission of this request does not imply you will receive services. In addition to this application, in order to be eligible for disability-related services, students must have a documented disabling condition as defined by the Americans with Disabilities Act of 1990 (ADA), ADA Amendments Act 2009 and Section 504 of the Rehabilitation Act of 1973.

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