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Online Student Application

Two easy steps to register
Welcome to Sinclair Accessibility Services! If you need to make changes to your accommodations, please log into AIM and follow the link for "Additional Accommodation Request".

In an effort to gather information about your potential needs, please provide information as outlined below. If a question does not apply, please enter N/A as all text boxes are required.

After completion of this form, please contact the Accessibility Services (937-512-5113) to set up an intake appointment. This appointment can be scheduled near the beginning of the semester or as soon as possible if the semester has begun. Accommodations cannot be addressed until consultation with the student is addressed.

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://www.sinclair.edu/services/welcome-center/registration-and-student-records/student-records/family-education-rights-privacy-act-ferpa/
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Select when you plan to graduate.
  3. Hint: Enter 7 alpha numeric characters.
  4. 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
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Permanent Address
  1. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  1. Secondary Disability(ies)

    ADHD/ADD

    Autism Spectrum Disorders (ASD)

    Learning Disability

    Medical

    Psychological Condition

    Sensory Conditions

    Unknown

  2. Affiliation(s)
  3. Ethnicity(ies)
  4. Campus Location(s)

Prior Accommodations

Alternative Testing
Questions
  1. Status (choose best answer based on your accommodation need) *
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