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Online Student Application

Two easy steps to register
Welcome to myAccess. Please complete this form as your first step in requesting disability accommodations and services through JCCC's Access Services. If you have any questions with this process, please contact us at myAccess@jccc.edu.

* indicates required information
Preferred Name should be your (the student's) preferred name.
Personal Information
  1. Note: Select when you would like to start your services.
  6. Hint: Enter 8 characters.
  7. Hint: Enter date in the following format Month/Day/Year (i.e. 12/31/2010).
Contact Information
  1. Hint: Enter 10-digit number only.
  2. Hint: Enter 10-digit number only.
  3. Hint: If you do not have a JCCC email available, please use an address you have access to.
Address
  4. Hint: Enter zipcode as 97331 or 97331-0000.
Additional Information
  2. Affiliation(s)
  3. Campus Location(s)
Please check all the accommodations you are requesting at Johnson County Community College.

Requesting Accommodations

Alternative Formats
Deaf and Hard of Hearing
Notetaking Services
Notetaking Support
Furniture and Equipment
Student Health Information
Technology
Testing Accommodations
Questions
  9. Do you need accommodations for any of the following? Please check all that apply: (leave blank if not applicable)
  12. How did you hear about Access Services?
  13. Are you currently working with a JCCC Academic Counselor? If yes, please list the name of your counselor. *
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