Online Student Application

Please complete the form below in it's entirety, as this will help us serve you quicker.

Once you have submitted this form you will have the opportunity to upload your documentation. Also, you will receive an email receipt with a link to upload the documentation at another time, if you prefer.

Please know that the information you provide will be kept private in accordance with the Family Education Rights & Privacy Act (FERPA). For more information on FERPA, please visit: https://www.wvc.edu/publicdisclosure/student-privacy-ferpa.html

Please email sas@wvc.edu or call 509-682-6854 if you need assistance with completing this form.

Personal Information

Start Term *:
Note: Select when you would like to start your services.
Expected Graduation Term:
Note: Select when you plan to graduate.
First Name *:
Last Name *:
Middle Name:
Optional: Preferred Name:
Student ID:
Hint: Enter 9 alpha numeric characters.
Birth Date:
Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Gender *:
Pronouns:

Contact Information

Primary Phone Number:
Hint: Enter 10-digit number only.
Secondary Phone Number:
Hint: Enter 10-digit number only.
Email Address *:

Questions

What is your disability and/or diagnosis? This may include physical, psychological, learning, and sensory disabilities. * (Required)
Please describe how your medical condition, symptoms, and medications impact you, particularly as a student at Wenatchee Valley College. * (Required)
Describe your history of previous accommodation use, if any. This may include disability accommodations at a previous college, workplace, high school IEP or 504 plans. * (Required)
Due to your disability, what accommodations do you feel you need at Wenatchee Valley College? If you are not sure, Student Access Services staff will discuss available options with you during the intake appointment * (Required)
Do you have medical documentation to support your accommodation request, such as a letter from a doctor or a counselor, IEP or 504 evaluation or case notes? * (Required)
How did you find out about Student Access Services? * (Required)

By completing this form and uploading documents you are providing consent and release of this information to Student Access Services at Wenatchee Valley College.

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