Welcome Meeting Request
Active Status
Active
Welcome Meeting Requested
Inactive
One Time Accommodation
Contact Information
First Name:
Last Name:
Email:
example@email.com
x
Phone Number:
()
x
Current Student Status at CSUEB?
Current Student
Prospective Student
Only taking standardized exam (MAT, TEAS, etc) and not enrolled at CSUEB
Admitted student for future semester
Other
Net ID:
What semester have you been admitted for?
Term Id
Other Student Status?
Accommodation Information
Reason for contacting Accessibility Services?
Need accommodations for my courses at CSUEB.
Need accommodations for TEAS, WST, or other standardized exam.
Would like to explore services offered through Accessibility Services.
Other
Other Reason?
Are you a 1st year student with Autism, seeking a referral to CLP?
Learn about CLP
No
Yes
Accommodations needed during your appointment?
None
Sign-language interpreter
Document in large print
Other
Other accommodations?
Please upload any relevant documents with Accessibility Services. (OPTIONAL)
Do you have any disability paperwork?
Yes, I have uploaded it
Yes, I will bring it to my Welcome Meeting
Yes, I will email it to as@csueastbay.edu before my Welcome Meeting
No, I do not
Would you like to opt in to receive Mobile SMS texts?
You are already an Active Student with Accessibility Services. Please email you Accessibility Counselor if you have questions or concerns. If you need to make an appointment, please contact
as@csueastbay.edu
.
Accessibility Counselor
Accessibility Counselor Email
Accessibility Counselor Id
Contact Information