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Welcome to Access Services! To help us serve you better, please complete the form below in it's entirety.
Please know that the information you provide will be kept private in accordance with the Family Education Rights & Privacy Act (FERPA). For more information on FERPA, please visit: http://www.olympic.edu/staff-faculty/institutional-research-planning-and-assessment/family-educational-rights-privacy-act.
Personal Information
Start Term
*
:
Select One
2024 - Spring
2024 - Summer
2024 - Fall
2025 - Winter
2025 - Spring
2025 - Summer
2025 - Fall
2026 - Winter
2026 - Spring
2026 - Summer
2026 - Fall
2027 - Winter
2027 - Spring
2027 - Summer
2027 - Fall
2028 - Winter
2028 - Spring
2028 - Summer
2028 - Fall
2029 - Winter
2029 - Spring
2029 - Summer
2029 - Fall
2030 - Winter
2030 - Spring
2030 - Summer
2030 - Fall
2031 - Winter
2031 - Spring
2031 - Summer
2031 - Fall
2032 - Winter
2032 - Spring
2032 - Summer
2032 - Fall
2033 - Winter
2033 - Spring
2033 - Summer
2033 - Fall
2034 - Winter
2034 - Spring
2034 - Summer
2034 - Fall
2035 - Winter
2035 - Spring
2035 - Summer
2035 - Fall
2036 - Winter
2036 - Spring
2036 - Summer
2036 - Fall
2037 - Winter
2037 - Spring
2037 - Summer
2037 - Fall
2038 - Winter
2038 - Spring
2038 - Summer
2038 - Fall
2039 - Winter
2039 - Spring
2039 - Summer
2039 - Fall
2040 - Winter
2040 - Spring
Note: Select when you would like to start your services.
Expected Graduation Term:
Select One
Pre 2010
2010 - Summer
2010 - Fall
2011 - Winter
2011 - Spring
2011 - Summer
2011 - Fall
2012 - Winter
2012 - Spring
2012 - Summer
2012 - Fall
2013 - Winter
2013 - Spring
2013 - Summer
2013 - Fall
2014 - Winter
2014 - Spring
2014 - Summer
2014 - Fall
2015 - Winter
2015 - Spring
2015 - Summer
2015 - Fall
2016 - Winter
2016 - Spring
2016 - Summer
2016 - Fall
2017 - Winter
2017 - Spring
2017 - Summer
2017 - Fall
2018 - Winter
2018 - Spring
2018 - Summer
2018 - Fall
2019 - Winter
2019 - Spring
2019 - Summer
2019 - Fall
2020 - Winter
2020 - Spring
2020 - Summer
2020 - Fall
2021 - Winter
2021 - Spring
2021 - Summer
2021 - Fall
2022 - Winter
2022 - Spring
2022 - Summer
2022 - Fall
2023 - Winter
2023 - Spring
2023 - Summer
2023 - Fall
2024 - Winter
2024 - Spring
2024 - Summer
2024 - Fall
2025 - Winter
2025 - Spring
2025 - Summer
2025 - Fall
2026 - Winter
2026 - Spring
2026 - Summer
2026 - Fall
2027 - Winter
2027 - Spring
2027 - Summer
2027 - Fall
2028 - Winter
2028 - Spring
2028 - Summer
2028 - Fall
2029 - Winter
2029 - Spring
2029 - Summer
2029 - Fall
2030 - Winter
2030 - Spring
2030 - Summer
2030 - Fall
2031 - Winter
2031 - Spring
2031 - Summer
2031 - Fall
2032 - Winter
2032 - Spring
2032 - Summer
2032 - Fall
2033 - Winter
2033 - Spring
2033 - Summer
2033 - Fall
2034 - Winter
2034 - Spring
2034 - Summer
2034 - Fall
2035 - Winter
2035 - Spring
2035 - Summer
2035 - Fall
2036 - Winter
2036 - Spring
2036 - Summer
2036 - Fall
2037 - Winter
2037 - Spring
2037 - Summer
2037 - Fall
2038 - Winter
2038 - Spring
2038 - Summer
2038 - Fall
2039 - Winter
2039 - Spring
2039 - Summer
2039 - Fall
2040 - Winter
2040 - Spring
Note: Select when you plan to graduate.
First Name
*
:
Last Name
*
:
Middle Name:
Preferred Name (Optional):
Student ID:
Hint: Enter 9 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
*
:
IMPORTANT NOTE
: The email address you listed above will be used by Student Disability Services to contact you regarding relevant and important information from our office. If the email you provided is not an Olympic College student email, please check your junk/spam folder for our emails.
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
Seeking Degree:
Select One
Associate in Applied Science (AAS)
Associate in Applied Science - Transfer (AAS-T)
Associate in Arts/Direct Transfer Agreement (AA/DTA)
Associate in General Studies (AGS)
Associate in Technical Arts Degree (ATA)
Associate of Science - Transfer (AS)
Bachelor of Applied Science (BAS)
Certificate
High School 21+ (HS21)
High School Completion/GED
Major:
Select One
Accounting
Administrative Office Support
Art
Business
Business Management
Business Technology
Chemical Dependency Counseling
Composites Manufacturing
Computer Information Systems/Computer Science
Cosmetology
Criminal Justice
Culinary Arts
Digital Film Making
Early Childhood Education
Education
Electronics
Engineering
English
Environmental Studies
Fashion Marketing
Homeland Security
Human Services
Industrial Trades Technician
Marine Science/Oceanography
Medical Assisting
Music
Nursing
Organizational Leadership
Physical Therapy Assistant
Political Science
Pre-Health Occupations
Pre-Law
Psychology
Science
Social Science
Social Work
Technical Design
Welding
Affiliation(s)
Affiliation(s)
International Student
Kitsap Mental Health Services (KMHS)
Labor & Industries (L&I)
OC Promise
PSNS (Apprenticeship)
PSNS (Helper School)
Running Start
Services for the Blind (DSB)
Skookum
Student Athlete
Veterans Affairs (VA)
Vocational Rehabilitation (DVR)
Workers Compensation (OWCP)
Ethnicity(ies)
Ethnicity(ies)
African-American
Asian
European-American
Hispanic
Multi-Racial
Native American
Other
Pacific Islander
Campus Location(s)
Campus Location(s)
Bremerton
Poulsbo
PSNS
Shelton
Additional Note:
Questions
Please describe your disability(ies) and/or diagnosis(es) you are seeking accommodations for.
Have you used accommodations in your previous school experience?
*
(Selection is Required)
Yes (Specify Below)
No
Additional Note or Comment
What classroom or academic accommodations are you requesting at this time?
Are you receiving Federal Financial Aid?
*
(Selection is Required)
Yes
No
I don't know
Additional Note or Comment
Are you receiving benefits from any agency?
*
(Selection is Required)
Yes (Specify Below)
No
I don't know
Additional Note or Comment
How did you learn about Student Disabilty Services?
Faculty
Academic Advisor
Fellow student
High school counselor or teacher
Received services at another college
Website
College presentation
Additional Note or Comment
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