SUNY Delhi Self Disclosure Form Students with Disabilities

Student Name Student Name * First Middle Last
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone * - ### - ### ####
SUNY Delhi Email *
Student 800# *
Must be 9 digits. Currently Entered: 0 digits.
Term of Entry *

Semester and year
Program *
Type of Disability *

Please be specific
On Campus

On Campus Students taking classes on the Delhi campus will be invited to attend a Bronco Ready Orientation program. During this visit, Gabriella Vasta, Coordinator, Access and Equity Services, will be available to review accommodations that are offered.*ALL CAMPUS STUDENTS WILL NEED A PERSONAL APPOINTMENT BEFORE THE START OF THE SEMESTER (after your documentation has been received) to address individual needs.
Online

Online Online students should submit a student self-assessment along with this self-disclosure. The self- assessment can be found on our website at www.delhi.edu/aes under the “Support for Online Students” link.
Partnership Site

Partnership Site Students taking classes on partnership campuses please refer to our website at www.delhi.edu/aes under the “Partnership School Services” link.
Please indicate which partnership site *
Upload Documentation (Maximum of five files)

Attach Files
Stay connected! – Important student information will be sent to your Delhi email address. Log in often to check your inbox for information regarding required paperwork from offices such as, Residence Life, Access and Equity, Health Services, Financial Aid, and more.

You may contact the Access and Equity Coordinator to discuss issues related to Access and Equity Services by calling (607) 746-4599.