WSU Tech Student Accessibility and Support Services (SASS)

WSU Tech works with students to ensure a positive educational experience and equal access to educational opportunities and programs. Students with disabilities may request academic accommodations by completing the information below, signing a Release of Information to allow Student Accessibility and Support Services staff to communicate with the appropriate personnel, and by providing documentation of disability completed by a licensed professional.

Please fill out this information below.
If you need assistance filling out the form below, please contact WSU Tech Student Accessibility and Support Services.
316.677.1065/Fax: 316.462.0716
sass@wsutech.edu

First Name

Middle Name

Last Name

Birthdate

Phone Number

Email Address

Mailing Address

Country

Street

City

Region

Postal Code

Student ID

High School Student (Currently Attending High School)

High School (Please type)

Current Program at WSU Tech

Please provide additional information on disability as needed

Please provide additional information on accommodations as needed

Accommodations and Auxiliary aids: Students are responsible for requesting accommodations or auxiliary aids at least three weeks before courses, programs or activities in which accommodations are needed. Students are responsible for requesting assistance for specialized support services from other resources such as State Vocational Rehabilitation, Recordings for the Blind, State Services for the blind, etc. I understand that I must provide medical or other diagnostic documentation of my disability and limitations, prepared by a qualified physician, psychologist, or professional to WSU Tech Student Accessibility and Support Services department.

Auxiliary Aid needed:

What kind of auxiliary aid is needed for the classroom?

My signature (typed full name) confirms that all information above is accurate to the best of my ability

Please list others you are giving WSU Tech Student Accessibility and Support Services permission to share information with (first and last name please):

I understand that I must provide medical or other diagnostic documentation of my disability and limitations, prepared by a qualified physician, psychologist, or professional, to Student Accessibility and Support Services. This confidential form will be in effect from the date signed and will remain effective during my registration at WSU Tech.

I understand that if I need to make changes to those I am giving permission for you to share my information, I will fill out a new form.

Signature Release of Information (please type full name)

Upload up to three documents (Disability Verification form, IEP (Individualized Education Plan), Section 504 Plan, Psychoeducational Evaluation or any other documentation completed by a licensed professional.