Accessible Learning Services Intake Form

Instructions

All information collected in this form is confidential. It is used to understand your disability-related needs and determine appropriate academic accommodations.ccommodations.

Who Should Complete This Form

This form is for learners enrolled in full-time or part-time academic programs at Humber Polytechnic.

Who Should Not Complete This Form

Do not complete this form if any of the following apply:

• You are enrolled in Continuous Professional Learning courses, including the Real Estate Program
• You are enrolled in courses at the University of Guelph-Humber

If this applies to you, please email our Client Care Facilitator Team at swac@humber.ca to complete your intake.

Before You Begin

• This form must be completed in one session. You cannot save and return later.
• Complete all required fields and upload your documentation when prompted.
• Use a desktop or laptop computer for the best experience.

Assistive Technology

Assistive Technology can be used to complete this form. Free screen readers such as Natural Readers or Read&Write are available.