Request Academic Accomodations First Name * Last name * Student ID # * Email * Telephone Date of Birth (mm/dd/yy) Enter information for the appropriate statement below (choose one). Which year are you entering your first fall semester in? Which year are you entering your first winter semester in? - OR - I am a current student at King's who has already connected with the Student Success Office. How many years at King's have you completed? Which semester are you in? How many courses are you taking? I am a current student at King's who hasn't connected with the Student Success Office before. How many years at King's have you completed? Which semester are you in? How many courses are you taking? Name of the last school(s) attended (secondary or post-secondary) Year of graduation or leaving last school Major/degree program at King's Anticipated date of graduation Are you eligible for Student Financial Aid? Yes No Unsure Have you applied for Student Financial Aid? Yes No If you have, were you approved for Student Financial Aid? Yes No Disability/Limitation Name of disability/limitation Date of diagnosis Documentation available? Yes No Was documentation given to Accessibility and Support Services? Yes No If you were provided with accommodations in high school or another post-secondary institution, what was helpful to you? (check all that apply) Extra time for tests/exams Writing tests/exams in a quiet environment Use of a computer for tests/exams Note taking Use of adaptive technology Other (please specify) Current Concerns Why are you seeking assistance from Accessibility and Support Services? How can Accessibility Services help you to be successful? (please be specific) Is there any other information you would like to share? Leave Blank This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.