Request an Intake Packet

In order to receive special accommodations, such as extended time on tests and note takers for college level classes, a student needs to be registered with the Department of Special Services. Intake forms must be completed and proper documentation must be provided specifying a disability.  To receive an intake packet in the mail, please fill out the form below.

	NAME
	ADDRESS
	CITY
	STATE
	ZIP CODE
	PHONE NUMBER
I plan to start classes the following semester: Fall Spring Summer I Summer II 2008 2009 2010