Student Intake Application

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Student Information

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Enrollment StatusRequired




Disability & Previous Accommodation Information

Have you previously received accommodations?Required
Are you working with the Office of Vocational Rehabilitation (OVR) or another vocational rehab office?Required
Are you working with Veteran's Affairs?Required
Are you requesting a housing accommodation?Required
Are you requesting an emotional support animal (ESA) to reside on campus with you?Required
Please select all that apply

Please describe the accommodations you are requesting at this time. Accomodations will be discussed in your welcome meeting. All accommodations are assigned on a case-by-case basis.

Supporting Documentation

Upload documentation of your disability, one document file at a time, by clicking the Add Item button below.

Upload disability supporting document(s)

Disability Verification forms can be found within the Documentation Requirements section of the Kean University Office of Accessibility Services website. The disability verification forms are provided to assist you in submitting the relevant information. These forms must be completed and signed by a licensed healthcare professional.

Please include a Documentation Cover Sheet with any supplemental evaluations or diagnostic reports you are submitting.

Confidentiality

By typing my initials in the box below, I authorize the Office of Accessibility Services at Kean University to disclose educational, psychological, and medical records or information that would assist the university in the design of reasonable accommodations to my disability.  

By typing my initials in the box below, I authorize the Office of Accessibility Services at Kean University to receive educational, psychological, and medical records or information that would assist the university in the design of reasonable accommodations to my disability.