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Online Student Application
Online Student Application
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By completing this Application you are requesting for the review of potential accommodations at The University of Akron.
By submitting the application listed below, you agree to the following:
I understand that
admission
to The University of Akron is a separate process.
I understand I must submit
documentation
of my disability(ies), be enrolled in classes and have a current class schedule prior to meeting with a specialist for an intake appointment.
I authorize the Office of Accessibility to contact my physician to clarify any questions regarding my documentation.
I understand that submitting this form does not automatically qualify me for accommodations and/or services.
I understand I will not be eligible to receive services until all documentation is provided and appropriate next steps are completed.
I understand that The University of Akron's Office of Accessibility determines documentation guidelines and what reasonable accommodations may be warranted based on the impact of disability(ies) and acknowledges that accommodation plans may differ between other public universities and the high school environment.
Personal Information
Start Term
*
:
Select One
2023 - Spring
2023 - Summer
2023 - Fall
2024 - Spring
2024 - Summer
2024 - Fall
2025 - Spring
2025 - Summer
2025 - Fall
2026 - Spring
2026 - Summer
2026 - Fall
2027 - Spring
2027 - Summer
2027 - Fall
2028 - Spring
2028 - Summer
2028 - Fall
2029 - Spring
2029 - Summer
2029 - Fall
2030 - Spring
2030 - Summer
2030 - Fall
2031 - Spring
2031 - Summer
2031 - Fall
2032 - Spring
2032 - Summer
2032 - Fall
2033 - Spring
2033 - Summer
2033 - Fall
2034 - Spring
2034 - Summer
2034 - Fall
2035 - Spring
2035 - Summer
2035 - Fall
2036 - Spring
2036 - Summer
2036 - Fall
2037 - Spring
2037 - Summer
2037 - Fall
2038 - Spring
2038 - Summer
2038 - Fall
2039 - Spring
2039 - Summer
2039 - Fall
2040 - Spring
2040 - Summer
2040 - Fall
2041 - Spring
2041 - Summer
2041 - Fall
2042 - Spring
2042 - Summer
2042 - Fall
2043 - Spring
2043 - Summer
2043 - Fall
2044 - Spring
2044 - Summer
2044 - Fall
2045 - Spring
2045 - Summer
2045 - Fall
Note: Select when you would like to start your services.
Primary Campus
*
:
Select One
Lakewood Campus
Law School
Main Campus
Medina County University Center
Wayne Campus
Note: Please select campus location where you will be enrolled.
Expected Graduation Term:
Select One
1990 - Fall
1991 - Spring
1991 - Summer
1991 - Fall
1992 - Spring
1992 - Summer
1992 - Fall
1993 - Spring
1993 - Summer
1993 - Fall
1994 - Spring
1994 - Summer
1994 - Fall
1995 - Spring
1995 - Summer
1995 - Fall
1996 - Spring
1996 - Summer
1996 - Fall
1997 - Spring
1997 - Summer
1997 - Fall
1998 - Spring
1998 - Summer
1998 - Fall
1999 - Spring
1999 - Summer
1999 - Fall
2000 - Spring
2000 - Summer
2000 - Fall
2001 - Spring
2001 - Summer
2001 - Fall
2002 - Spring
2002 - Summer
2002 - Fall
2003 - Spring
2003 - Summer
2003 - Fall
2004 - Spring
2004 - Summer
2004 - Fall
2005 - Spring
2005 - Summer
2005 - Fall
2006 - Spring
2006 - Summer
2006 - Fall
2007 - Spring
2007 - Summer
2007 - Fall
2008 - Spring
2008 - Summer
2008 - Fall
2009 - Spring
2009 - Summer
2009 - Fall
2010 - Spring
2010 - Summer
2010 - Fall
2011 - Spring
2011 - Summer
2011 - Fall
2012 - Spring
2012 - Summer
2012 - Fall
2013 - Spring
2013 - Summer
2013 - Fall
2014 - Spring
2014 - Summer
2014 - Fall
2015 - Spring
2015 - Summer
2015 - Fall
2016 - Spring
2016 - Summer
2016 - Fall
2017 - Spring
2017 - Summer
2017 - Fall
2018 - Spring
2018 - Summer
2018 - Fall
2019 - Spring
2019 - Summer
2019 - Fall
2020 - Spring
2020 - Summer
2020 - Fall
2021 - Spring
2021 - Summer
2021 - Fall
2022 - Spring
2022 - Summer
2022 - Fall
2023 - Spring
2023 - Summer
2023 - Fall
2024 - Spring
2024 - Summer
2024 - Fall
2025 - Spring
2025 - Summer
2025 - Fall
2026 - Spring
2026 - Summer
2026 - Fall
2027 - Spring
2027 - Summer
2027 - Fall
2028 - Spring
2028 - Summer
2028 - Fall
2029 - Spring
2029 - Summer
2029 - Fall
2030 - Spring
2030 - Summer
2030 - Fall
2031 - Spring
2031 - Summer
2031 - Fall
2032 - Spring
2032 - Summer
2032 - Fall
2033 - Spring
2033 - Summer
2033 - Fall
2034 - Spring
2034 - Summer
2034 - Fall
2035 - Spring
2035 - Summer
2035 - Fall
2036 - Spring
2036 - Summer
2036 - Fall
2037 - Spring
2037 - Summer
2037 - Fall
2038 - Spring
2038 - Summer
2038 - Fall
2039 - Spring
2039 - Summer
2039 - Fall
2040 - Spring
2040 - Summer
2040 - Fall
2041 - Spring
2041 - Summer
2041 - Fall
2042 - Spring
2042 - Summer
2042 - Fall
2043 - Spring
2043 - Summer
2043 - Fall
2044 - Spring
2044 - Summer
2044 - Fall
2045 - Spring
2045 - Summer
2045 - Fall
Note: Select when you plan to graduate.
First Name
*
:
Last Name
*
:
Middle Name:
Preferred Name
*
:
Student ID:
Hint: Enter 7 alpha numeric characters.
Birth Date
*
:
Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Gender
*
:
Select One
Female
Male
Not Specified
Transgender
Contact Information
Cell Phone Number:
Hint: Enter 10-digit number only.
Land Line Phone Number:
Hint: Enter 10-digit number only.
Email Address
*
:
Local Address
Address
*
:
City
*
:
State
*
:
Select One
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Wyoming
International
Zipcode
*
:
Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address
Same as Local Address
Address:
City:
State:
Select One
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Wyoming
International
Zipcode:
Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
Ethnicity(ies)
Ethnicity(ies)
African American
Asian American
Biracial
Caucasian
Hispanic
International
Native American
Other
Additional Note:
Questions
Are you a current UA student? If yes, what is your major and the college to which the major belongs? If no, what is your anticipated enrollment date and major?
*
(Selection is Required)
Yes (If yes, please indicate your major and college below)
No
Additional Note or Comment
Are you registered with the Opportunities for Ohioans with Disabilities (formally Bureau of Vocational Rehabilitation) or the Bureau of Services for the Visually Impaired (BSVI)?
*
(Selection is Required)
Yes (If yes, what is your counselor or case manager's name?) (Specify Below)
No
Additional Note or Comment
Are you requesting Residence Life and Housing accommodations due to a disability? If yes, please explain.
*
(Selection is Required)
Yes
No
Additional Note or Comment
What is your current status?
College Credit Plus (CCP)
Incoming Student
First Year (0 - 31.99 credits completed)
Sophomore (32 - 63.99 credits completed)
Junior (64 - 95.99 credits completed)
Senior (96+ credits completed)
Graduate Student
Law Student
Transfer Student
Additional Note or Comment
Disability Information: Please check all that apply
Acquired Brain Injury
Attention Deficit Hyperactivity Disorder
Autism Spectrum Disorder
Chronic Health Condition
Deaf/Hearing Impairment
Intellectual Disability/Specific Learning Disorder
Mobility Impairment
Neurological Condition
Physical Disability
Psychological Disability
Temporary Medical Condition
Visual Impairment
Additional Note or Comment
Using your own words, please describe your disability(ies) and how it impacts you in an academic setting.
*
(Required)
Please list any current medications or therapies you are receiving.
*
(Required)
What accommodations have you previously used, if applicable?
*
(Required)
Please list the accommodations and services you are requesting. Please note: Accommodations must be supported by documentation submitted to the office.
*
(Required)
If applicable, please list any adaptive technologies you will be using.
*
(Required)
Will you have a Personal Care Assistant (PCA)?
*
(Selection is Required)
Yes
No
Additional Note or Comment
Are you an individual that would need assistance in an emergency evacuation situation? If so, please elaborate below.
*
(Required)
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