Registration Form

* indicates a required field

Student Information

Please use an email address that you check regularly.

Accessibility Specific Information

Please let us know what types of academic supports you may be looking for or the types of academic difficulties you may be having due to a disability.
Do you have documentation from a medical professional supporting the need for academic accommodation?
i.e. physician, psychologist, psychiatrist, etc.
Upload supporting document(s)
This maybe provided during your intake appointment if you do not have it available at this time. If you do not have documentation, please still continue the registration process as our team will work with you on possible ways to obtain this.
Confidentiality StatementRequired

Accessibility Services is responsible for receiving and retaining medical and/or psychological information provided by students requesting academic accommodation. Your information is confidential and will not be shared with anyone outside of Accessibility Services without your written consent. There are 3 exceptions to this: If you or another person is at risk of serious harm, If you admit to child abuse or child neglect, or If your information is subpoenaed in a court of law.

If you have any concerns regarding this confidentiality consent, please contact our office directly at 780-539-2017 or AS@nwpolytech.ca.

By providing consent, you are allowing Accessibility Services to communicate specific information regarding your academic accommodations and disability information to the following individuals. This consent does not include the sharing of information such as tuition and fees. Consent for this must be provided to Student Services.

I give permission to Accessibility Services to share information with the following individuals: (Specify by name - not "Mom"). You may update this list at any time by contacting our office.