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Online Student Application

Two easy steps to register
Welcome to the Center for Accessibility and Neurodiversity online application and accommodation system. Please complete the form below in it's entirety; it will help us serve you better!

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: https://www2.ed.gov/policy/gen/guid/fpco/ferpa/index.html
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  7. Hint: Enter your 7 digit numeric ID.
  8. Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Contact Information
  1. Hint: Enter 10-digit number only.
  2. Hint: Enter 10-digit number only.
Local Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  3. Affiliation(s)
Please check all the accommodations you had at a previous institution. Please note that previous accommodations and eligibility for future accommodations will be discussed during intake.

Prior Accommodations

Alternative Testing
Alternative Formats
Additional Accommodations and Services
Notetaking Services
Campus Access
Please check all the accommodations you are requesting at Illinois Valley Community College. All requests will be reviewed, then discussed during intake. Checking boxes here does not guarantee these accommodations will be provided.

Requesting Accommodations at CAN

Alternative Testing
Alternative Formats
Additional Accommodations and Services
Notetaking Services
Campus Access

Questions

  2.  
    How did you hear about The Center for Accessibility and Neurodiversity
  3.  
    Have you ever received accommodations at another school? * (Selection is Required)
  4.  
    Are you a: * (Selection is Required)

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