Form Beyond Access Application Student InformationStudent Name(Required) First Last Chosen or Preferred NamePronounse.g., She/Her/Hers, He/Him/His, They/Them/TheirsEmail Address(Required) Enter Email Confirm Email Please select the statement that best describes your connection with UConn.(Required) I am a current UConn student. I am an incoming student. I have accepted an offer of admission as a first year or transfer student. I am an admitted student, but I am unsure whether I will attend UConn. I am a prospective student. I am searching for colleges, and I am interested in UConn. How did you find out about the Beyond Access program?(Required) UConn Center for Students with Disabilities website UConn Center for Students with Disabilities employees UConn Faculty/Staff (external to Center for Students with Disabilities) UConn Admissions High School staff (e.g., guidance counselor, school psychologist, teacher, transition coordinator) Center for Students with Disabilities printed brochures Personnel at another college or university College Transition Publications (e.g., Princeton Review, Kaplan, College STAR) Word of mouth Parent/family member Web search Other The Beyond Access Application is intended for current and incoming UConn students who intend to participate in Beyond Access in the present or upcoming term. Based on your responses, you are not eligible to complete the application at this time. If you believe that this is incorrect, please revise your application or contact Allison Knight at csdbeyondaccess@uconn.edu. Prospective students and admitted students who have not yet committed to UConn may learn more about Beyond Access by attending a Prospective/Admitted Student Information Session. Sessions will introduce students to the Center for Students with Disabilities (CSD) at UConn and discuss the differences between high school and college accommodation request and coordination processes. Additionally, information about Beyond Access will be shared. There will also be an opportunity to ask questions. Parents and family members are welcome! If upcoming session dates are not listed on the website, please contact csd@uconn.edu for more information. You may email Allison Knight at csdbeyondaccess@uconn.edu to request information, ask questions, and/or schedule a meeting to discuss Beyond Access. Cell Phone(Required)Parent/Guardian/Emergency Contact Name(Required) Parent/Guardian/Emergency Contact Email(Required) Enter Email Confirm Email Class Standing(Required) Incoming first year student Incoming transfer student First year Sophomore Junior Senior Graduate Student Non-degree Other Semester of Intended Beyond Access Participation(Required) Current semester Upcoming Fall semester Upcoming Spring semester Summer intercession Winter intercession Do you identify as an individual with a disability, disabled, neurodivergent, a person who learns differently, or similar?(Required) Yes No How would you explain your disability, condition, neurodivergence, or difference to others?(Required)Please review the list of academic skills and identify your strengths or skills you feel are your strongest and any concerns. Provide specific information about any difficulties you experience (e.g., Study skills – I don’t have much experience studying for exams and I’m not sure how to study effectively). Completing homework assignments General study skills Memory Concentration/maintaining focus Class participation Notetaking Reading Writing Math Taking tests and exams Answer here:(Required)Please review the list of college skills and identify your strengths or skills you feel are your strongest and any concerns. Provide specific information about any difficulties you experience (e.g., Time management – I have trouble planning so that I have enough time to complete all my tasks. I rush through assignments at the last minute and my grades have suffered.). Communicating with teachers, faculty, and staff Self-knowledge and self-advocacy Time management Organization Communicating with other students Awareness of UConn offices and resources Career preparation Living in a residence hall Answer here:(Required)Please review the list of social skills and identify your strengths or skills you feel are your strongest and any concerns. Provide specific information about any difficulties you experience (e.g., Participating in conversation one-on-one – I do okay in small groups because the focus is split between everyone, but one-on-one I struggle to decide how to respond and keep the conversation going.). Identifying clubs and organizations related to your interests Attending club meetings Participating in conversation one-on-one Participating in conversation in a group setting Attending large group events Making new friends Initiating conversation Asking questions in conversation Talking about topics that are not of interest to you Identifying the closeness of a relationship Answer here:(Required)Please review the list of personal and wellness skills and identify your strengths or skills you feel are your strongest and any concerns. Provide specific information about any difficulties you experience (e.g., Maintaining a daily routine – I’m often awake until 3am which makes it hard to wake up in the morning.). Maintaining a daily routine (e.g., sleep schedule, medication management) Diet and exercise Stress management Extracurricular activity involvement Adapting to change Answer here:(Required)What are your expectations of Beyond Access? What do you hope to get out of the program?(Required)How do you learn best? What has not worked for you in the past?(Required)Do you use technology to support any of the following skills? Reading Writing Notetaking Time management Communication Stress management Other Please provide a brief explanation of the type of technologies you use to help with your academic and social obligations.(Required)Any additional information you would like to share with us:How did you find out about the Beyond Access program?(Required) UConn Center for Students with Disabilities website UConn Center for Students with Disabilities employees UConn Faculty/Staff (external to Center for Students with Disabilities) UConn Admissions High School staff (e.g., guidance counselor, school psychologist, teacher, transition coordinator) Center for Students with Disabilities printed brochures Personnel at another college or university College Transition Publications (e.g., Princeton Review, Kaplan, College STAR) Word of mouth Parent/family member Web search Other Your records and personal information are subject to the Family Educational Rights and Privacy Act of 1974 (FERPA) and may only be disclosed with your permission or as provided under the law. For example, FERPA permits schools to disclose your information in the event of a health or safety emergency as determined by University employees. Please refer to the UConn Privacy Program’s information regarding FERPA to learn more. Any information used for research purposes will not include your name or other identifying information.Select one of the following authorizations regarding the release of information pertaining to you for the purpose of assisting you in your program.(Required) I authorize CSD to discuss with my parents or family members any academic or personal information pertaining to me. I authorize CSD to discuss with only specified parents or family members any academic or personal information pertaining to me. I do not authorize CSD to discuss with my parents or family members any academic or personal information pertaining to me. List authorized individuals:(Required)EmailThis field is for validation purposes and should be left unchanged.