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Accessibility Services

Application for Accessibility Services

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ApplyVisitRequest Info
Accessibility Services
  • Apply for Services
    • Application for Accessibility Services
    • Your Rights and Responsibilities
    • Documenting a Disability
    • Schedule a Proctored Exam
  • Resources
    • Transitioning to BSU
    • Common Accommodations
    • Accessibility Maps
    • For Faculty & Staff
      • Syllabus Statement
      • Creating An Accessible Course
      • Non-Discrimination Statements
    • AHEAD
  • Complaints and Grievances
  • Contact

BSU Accessibility Services Application

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Which school are you attending?*
MM slash DD slash YYYY
Name*
Do you accept text messages?
Local Address
Preferred course delivery method*
Have you applied for services with TRIO?*
If you had to categorize your disability, please check all the boxes that apply:*
Have you used or do you currently use any assistive technology?
In High School, were you enrolled with the Special Education Program?
According to the Americans with Disabilities Act, a disability is defined to be a physical or mental impairment that substantially limits a major life activity. Please indicate from the following list, which major life activities are substantially limited by your disability:*
If you are working with another agency to help support your education, please list them here.
Examples include Vocational Rehabilitation, Veteran’s Affairs, Social Services.
If you would like Accessibility Services to be able to speak to anyone outside of the BSU/NTC community about your records and information with our office, please list them below
Name
Relationship
Contact Information
 

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Bemidji State University

1500 Birchmont Drive NE
Bemidji MN 56601-2699

(218) 755-2001 | (800) 475-2001
TTY: (800) 627-3529

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