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Online Student Application

Two easy steps to register
Welcome to myAccess! Please complete this application as your first step in qualifying for and requesting disability accommodations.

Questions? Contact us at myAccess@jccc.edu or 913-469-3521.

* 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 Testing
Alternative Formats
Deaf and Hard of Hearing
Notetaking Services
Notetaking Support
Furniture and Equipment
Student Health Information
Technology

Questions

  8.  
    Do you need accommodations for any of the following? Please check all that apply: (leave blank if not applicable)
  11.  
    How did you learn of Access Services?
  12.  
    Are you currently working with a JCCC Counselor or Success Coach? If yes, please list their name(s). * (Selection is Required)
  13.  
    Are you working with Kansas Vocational Rehabilitation Services? If yes, Please list the name and contact information for your counselor. * (Selection is Required)
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