Skip to Main Content Skip to Tabs Skip to Sub-Tab Navigation

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 7 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)
The Access Services Office ensures that your disability information remains confidential and will not be shared with others without your consent. However, we will work closely with Western co-workers, such as faculty, advisors, and counselors/case management staff, to coordinate the necessary support and services to meet your individual needs. Please also note that your affiliation with Access Services will be recorded in our Customer Relationship Management (CRM) system.

Submitting this request does not guarantee that you will receive services. To be eligible for disability-related support, you must also have a documented disabling condition as defined by the Americans with Disabilities Act (ADA), the ADA Amendments Act of 2009, and Section 504 of the Rehabilitation Act of 1973.

If you have questions or concerns, please contact us at 608.785.9524 or AccessServices@westerntc.edu.

Licensed to Accessible Information Management LLC Copyright © 2010-2025 by Haris Gunadi. All rights reserved.