Online Student Application

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 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.

Personal Information

Start Term*:
Note: Select when you would like to start your services.
Primary Campus*:
Note: Please select campus location where you will be enrolled.
Expected Graduation Term:
Note: Select when you plan to graduate.
First Name*:
Last Name*:
Middle Name:
Optional: 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*:

Contact Information

Cell Phone Number:
Hint: Enter 10-digit number only (i.e. enter 9998888888 for 999 888 8888).
Land Line Phone Number:
Hint: Enter 10-digit number only (i.e. enter 9998888888 for 999 888 8888).
Email Address*:

Local Address

Permanent Address Same as Local Address

Additional Information

Questions

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