Access To Higher Education:

Students with Disabilities Speak Out

REGISTRATION FORM

Name:

Address:

City, State, Zip:

Telephone:

E-mail:

College or University Affiliation:

Role (i.e., Student, Faculty, Administrator):

ACCOMMODATIONS

Please indicate all that may apply:

I will need print materials in: Large Print Braille Audiotape
I will need a Sign Language Interpreter.
I will need other accommodations (please specify):___________________________________

Return this registration form to:

Debbie Simms
Center on Human Policy
Syracuse University, School of Education
805 South Crouse Avenue
Syracuse, NY 13244-2280
315-443-4355 · FAX 315-443-4338
dasimms@syr.edu

These links will take you to a new window:

[Link to Brochure in PDF] [Link to Brochure in HTML ] [Link to Registration Form in PDF] [Link to Registration Form in HMTL] [Link to Directions in PDF] [Link to Directions in HTML] [Link to Parking Map]