Student Disability Disclosure Form

* indicates a required field

Student Information

Include any leading zeroes (ex: 0000000)
Please use your university issued email address
Are you the first person in your family to attend college?
Are you in the military or are you a veteran?
Are you a non-degree student?
Are you a transfer student?
Are you attending WCU for summer session(s) only?
Do you live on campus?

Disability/Diagnostic Information

Select your disability/disabilities
Choose all that apply
{"display_name":"Select your disability\/disabilities","hidden_field_name":"ms_field_1","init_id":"ms_field_1","init_link":"","has_autocomplete":false,"has_hierpicklist":null}
Check any of the Life Activities listed below that you believe are affected as a result of your diagnosed condition(s)
Choose all that apply
{"display_name":"Check any of the Life Activities listed below that you believe are affected as a result of your diagnosed condition(s)","hidden_field_name":"ms_field_2","init_id":"ms_field_2","init_link":"","has_autocomplete":false,"has_hierpicklist":null}
Have you received accommodations previously?

Accommodation Information

**all documentation MUST include the name of the student AND the name and credentials of the evaluating provider or Local Education Agency (for IEPs and 504 Plans)**

All pages of a document should be submitted as a single file. Only PDF and DOCX files can be submitted. Image files are NOT accepted. 

Drop files here to upload
By signing below, I am certifying that I am, in fact, the student requesting accommodations through The Office of Educational Accessibility (OEA).