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

Online Student Application

Two easy steps to register
Welcome to the Access Center at Volunteer State Community College! Once you've submitted your application and documentation of disability, we'll work with you to eliminate barriers and improve access in your classes. We'll also communicate with you about your next steps.

Please note the following:
-All communication from AC will be sent to your official Vol State email address.
-Both this form and appropriate documentation must be received before our work together can proceed.
-We sometimes request additional documentation to support accommodation requests.
-We recommend accommodations based on the information you provide.
-It is your responsibility to notify us if your accommodations are not effective, so we can help you identify the barriers to your success.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Please select campus location where you will be enrolled.
  3. Note: Select when you plan to graduate.
  8. Hint: Enter 9 alpha numeric characters.
  9. 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.
  3. Hint: Please use your Vol State email.
Local Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address

  4. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  2. Secondary Disability(ies)

    Attention Disorder

    Autism Spectrum Disorders

    Deaf/HoH

    General Category

    Health Impairment

    Intellectual Disability

    Learning Disability

    Neurological Impairment

    Physical Impairment

    Psychological Impairment

    Temporary

    Visual Impairment

  6. Affiliation(s)
  7. Campus Location(s)
Please specify if you've previously used any of the following services. These may have been services provided at your high school or another college/university. If none of these apply, please leave blank.

Prior Accommodations

Alternative Formats
Deaf and Hard of Hearing
Lecture Material Access
Please select any of the following services you intend to request from our office. We need advance notification for these services since they may require additional planning. If none of these apply, please leave blank.

Requesting Accommodations at AC

Deaf and Hard of Hearing
Others
Chronic Disability Symptoms

Questions

  1.  
    Select all of the following classroom activities that create barriers for you.
  2.  
    Select all of the following skills that are problematic for you.
  3.  
    Select all of the following life situations that make it difficult for you to do well in school.
Licensed to Accessible Information Management LLC Copyright © 2010-2024 by Haris Gunadi. All rights reserved.