Registration Form

* indicates a required field

Student Information

Greetings and welcome to the Accessibility Center at UW Oshkosh!

We recognize the diversity of abilities and challenges that each student brings to our campus. Our team is here to provide the accommodations and support services to meet your unique needs.

Our mission is to collaboratively engage with you throughout the interactive process, aligning with the principles set forth in the Americans with Disabilities Act (1990), the ADA Amendments of 2011, and Section 504 of the Rehabilitation Act (1973).

At the heart of our mission is the belief that every student deserves equal opportunities to excel academically. We understand that your journey may present unique circumstances, and we are here to assist you in identifying and implementing accommodations that foster your success.

First NameRequired *

Last NameRequired *

Middle Name

Name Used

Pronouns

Student IDRequired *

EmailRequired *

Please use your university issued email address

Phone NumberRequired *

Are you interested in receiving text reminders?Required *

Are you interested in receiving text reminders? Yes Are you interested in receiving text reminders? No

Preferred Method of ContactRequired *

Phone Email

Permanent AddressRequired *

CampusRequired *

Oshkosh Fond du Lac Fox Cities Online

Veteran?Required *

Veteran? Yes Veteran? No

Important Information for Veterans:

The University of Wisconsin Oshkosh Veterans Resource Center (VRC) is a comprehensive support office with a mission of providing essential veterans educational benefits information, certifying veteran programming as well as campus and community resources coordination. Our goal is to empower our veterans, service members and military spouses and dependents with the tools necessary for achieving their academic goals.

Important Information regarding Title IX

The Title IX Discrimination and Sexual Misconduct Office at UW Oshkosh affords supportive measures and accommodations for pregnant and parenting students and students impacted by sexual harassment, sexual assault, domestic violence, dating violence, stalking, and all forms of sex discrimination. Students are not required to disclose this type of private information outside of the Title IX Office. Meeting with the Title IX Office will ensure that students are informed of their rights and does not initiate an investigation.

Please note that all staff in the Accessibility Center are mandatory reporters to the Title IX office.

Academic Information

What is your current class standing?Required *

First Year (0-29 cred.) Second Year (30-59 cred.) Third Year (60-89 cred.) Fourth Year (90+ cred.)

What semester and year did you first enroll at UW-Oshkosh?Required *

What semester and year did you first enroll at UW-Oshkosh? Fall What semester and year did you first enroll at UW-Oshkosh? Spring What semester and year did you first enroll at UW-Oshkosh? Summer

Specify YearRequired *

Check all that apply:Required *

Part-time Full-time Transfer Student Online Student Graduate Student

Documentation

In order to be determined eligible to receive accommodation services, the student must submit documentation from a qualified professional that verifies that a condition exists that substantially limits a major life activity (i.e. walking, seeing, breathing, hearing, learning, communicating, etc.). While IEP and 504 plans are welcome, they may not be sufficient documentation for eligibility purposes, depending upon the content and the identified disability.

Important Information:

Documentation Guidelines:

Documentation for Academic Accommodations can be found here.
Documentation for Dining Accommodations can be found here.
Documentation for Parking Accommodations can be found here.
Documentation for Housing Accommodations can be found here.
Documentation for an Assistance Animal (Emotional Support Animal) can be found here.

Not sure where to get documentation? Start with the UWO Student Health Center and Counseling Center.

The Student Health Center at UW Oshkosh offers healthcare services to currently enrolled students. If you are interested in making an appointment, please call (920) 424-2424.
The Counseling Center at UW Oshkosh is a center of encouraging, compassionate professionals who engage students in overcoming challenges and achieving wellness while honoring the dignity and worth of each person. If you are interested in making an appointment, please call (920) 424-2061.

Upload supporting document(s)

Disability Information

Please select your Primary DisabilityRequired *

Please select your secondary disability(ies).

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Please select your tertiary disability(ies)

{"display_name":"Please select your tertiary disability(ies)","hidden_field_name":"ms_field_2","init_id":"ms_field_2","init_link":"","has_autocomplete":false,"has_hierpicklist":null}

If other (explain below):

Accommodations Requested

Are you requesting classroom accommodations?Required *

Are you requesting classroom accommodations? Yes Are you requesting classroom accommodations? No

I am requesting the following classroom and campus accessibility service(s):Required *

Classroom Documentation Requirements:

Psychiatric-Psychological-Disability.pdf (uwosh.edu)

Medical-Condition.pdf (uwosh.edu)

Are you requesting housing accommodations?Required *

Are you requesting housing accommodations? Yes Are you requesting housing accommodations? No

I am requesting the following housing accessibility service(s):Required *

Have you submitted your housing application?Required *

Have you submitted your housing application? Yes Have you submitted your housing application? No

Housing Accommodation Documentation Information

Housing-Doc-.pdf (uwosh.edu)

Assistance-Animal-Documentation-Requirements.pdf (uwosh.edu)

PLEASE COMPLETE YOUR HOUSING APPLICATION.

Are you requesting parking accommodations?Required *

Are you requesting parking accommodations? Yes Are you requesting parking accommodations? No

I am requesting the following parking accommodation(s):Required *

Parking Accommodations Documentation Information

Psychiatric-Psychological-Disability.pdf (uwosh.edu)

Medical-Condition.pdf (uwosh.edu)

Are you requesting dining accommodations?Required *

Are you requesting dining accommodations? Yes Are you requesting dining accommodations? No

I am requesting the following dining accommodation(s):Required *

Dining Accommodation Documentation Information:

Psychiatric-Psychological-Disability.pdf (uwosh.edu)

Medical-Condition.pdf (uwosh.edu)

Authorization

I give my permission for information regarding my Individualized Accommodation Plan to be shared with the following individuals. I understand that I can submit a written statement revoking or changing this authorization at any time.

Authorization - Parent or Guardian:Required *

Authorization - Academic Advisor:Required *

Authorization - Other:

I give permission for my accommodation plan to be shared with testing servicesRequired *

I give permission for my accommodation plan to be shared with testing services Yes I give permission for my accommodation plan to be shared with testing services No I give permission for my accommodation plan to be shared with testing services N/A

Submission of this request does not imply you will receive services. In addition to this application, in order to be eligible for disability related services, students must have a documented disabling condition as defined by the Americans with Disabilites Act of 1990 (ADA), ADA Amendments Act 2009 and Section 504 of the Rehabilitation Act of 1973.

Referral Source:Required *

Seeking Additional Support?

Consider applying to Project Success in conjunction with the Accessibility Center. What is Project Success? Project Success is a remedial program for students with dyslexia and other language-based learning disabilities attending UW Oshkosh. Project Success provides individualized support in the form of organizational tutoring, which assists students with executive function skills. The program is one of the few university programs in the country that provides individualized support to students to promote academic independence. The program also provides an opportunity for students to prepare for college through the annual summer bridge program.

Project Success Registration

Are you interested in registering with Project Success (dyslexia, language-based or learning disability, or ADHD)? You can find more information here.

Yes

Student SignatureRequired *

DateRequired *

Registration Form

Student Information

Academic Information

Documentation

Disability Information

Accommodations Requested

Document Information