Online Form - Student Inquiry about DSPS

If you are a student with a disability interested in attending Cuesta College and would like information sent to you, please complete this form, or send an e-mail to dspsinfo@cuesta.edu.

Your Information

First Name:
Last Name:
Phone:
E-mail:
Address:
City:
State:	Please choose: Alabama Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska New Hampshire New Jersey New Mexico Nevada New York No. Carolina No. Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island So. Carolina Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code:
Date:
Contact Me:	By Mail         By E-Mail         By Phone

Information Requested

Send Applications:	DSPS Application Cuesta College Application
Send Forms:	Verification of Disability (VOD) Consent for Release of Information Form
Send Brochures:	Disabled Student Programs and Services Brochure Assistive Technology Center Brochure Academic Support Center Brochure Alternate Media Brochure Cuesta College Catalog

Preferred Format

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Page maintained by dspsweb@cuesta.edu. Last modified: 11/14/2003.