Accessibility Services Registration Form

Student Information

This form is to be filled out by the YSU student. Please fill out the form once.

If you have any questions, addtions or changes on this form, please contact the Accessibility Services Office: accessibility@ysu.edu.

Documentation requirements can be found here: https//ysu.edu/academic-success-center/accessibility-services/for-students/documents-required

First Name

Preferred Name

(If different from your first name)

Last Name

Middle Name

Student ID

Please use your university issued email address

Student's Cell Phone Number

Are you a veteran?

Are you an athlete?

Are you working with the Bureau of Vocational Rehabilitation (BVR) or Opportunities for Ohioans with Disabilities (OOD)?

My diagnosed disability falls into the following category

I am requesting

Please describe the accommodations you are requesting at this time.

Accommodations will be discussed in your registration meeting. All accommodations are assigned on a case by case basis.

Upload supporting document(s)

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