Beyond Access Application

Returning BA Students do NOT need to fill out this form again. Go directly to Program Agreement Forms to find the Participation Agreement for the upcoming semester.

Complete this application so we can learn more about you and match you with a Strategy Instructor who best meets your needs.

The application should be completed primarily by the student participant, with support from family members or friends only as needed.

Comments

This field is for validation purposes and should be left unchanged.

Student Name(Required)

First Last

Chosen or Preferred Name

Pronouns

e.g., She/Her/Hers, He/Him/His, They/Them/Theirs

Email 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)

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

Campus(Required)

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

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)

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)

After Submitting

Confirmation – You will receive automatic confirmation of receipt at the email address you enter in this form. If you do not receive a confirmation email, you entered an incorrect email address or your form was not received and you will need to resubmit. We recommend that you maintain a copy of your responses in case your application is not received.

Enrollment Agreements – Note that all enrollment forms (not just the application) must be completed to be eligible for a space in the program.

Questions?

Contact csdbeyondaccess@uconn.edu

After Submitting

Questions?

Main Office Location

Contact Information

Office Hours

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