Online Student Application

Welcome to mySAS. Please complete the form below in it's entirety. This will help us serve you better!

Once you have submitted this form you will have the opportunity to upload your documentation. You will also 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 help filling out 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

Please, state your disability/diagnosis. * (Required)
How would you categorize your disability or barrier? Please, check all that apply.

1. Deaf/Hearing

2. Mobility

3. Speech/Language (i.e Stuttering, Mutism, etc.)

4. Learning Disability (i.e. ADHD, Dyslexia, etc.)

5. Blind/Visual

6. Chronic/Acute Health (i.e. Autoimmune Disorders, Cancer, IBS, Allergies, Cardiac, etc.)

7. Neurological/Nervous System (i.e. Seizure, Concussion, Motor Neuron, Autism, etc.)

8. Psychological/Emotional (i.e. Anxiety, Depression, PTSD, Eating Disorders, etc.)

9. Other

Additional Note or Comment
Please, provide an in-depth description of functional limitations caused by your condition. (How does your condition affect you?) * (Required)
What accommodation(s) do you feel you need at Wenatchee Valley College due to your disability and functional limitations? * (Required)
Describe your history of accommodation use (ie. IEP, 504, accommodations at a previous college)? * (Required)
Is there any additional information you want included in your application? * (Required)
Who referred you to 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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