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Accessible Learning Registration Form

Two easy steps to register
Note: Read our Disability Documentation Requirements before completing the form below.

Your registration with Accessible Learning cannot be completed until you submit supporting disability documentation.

Information collected through this form and supporting documentation is held in strictest confidence. View our Statement of Confidentiality for more information.
Personal Information
  1. Note: Select when you would like to start your services.
  2. Note: Please select campus location where you will be enrolled.
  3. Hint: Enter 9 alpha numeric characters.
Contact Information
  1. Hint: Enter 10-digit number only.
Local Address
  1. Hint: Enter zipcode as N2L 3G1.
Additional Information
  1. Secondary Disability(ies)

    Non-Physical Disability

    Other

    Physical Disability

Questions

  1.  
    Please select the following statements that apply to you; I am a/an:
  2.  
    Have you registered with Accessible Learning before? * (Selection is Required)
  3.  
    What supports are you interested in speaking with Accessible Learning about? Please check all that apply.
  4.  
    Can Accessible Learning staff leave confidential voicemails at the phone number you have provided? * (Selection is Required)
  5.  
    Please confirm you have read the following statements by checking EACH of the boxes below.
  6.  
    Your registration with Accessible Learning cannot be completed until you submit supporting disability document. Tell us when you will submit your documentation: Documentation Guidelines
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