SSD Funding Request Policy Application Form

This is the foundation for a funding application, though both itemized receipts or items quotes AND documentation from a registered medical professional must be included.
  • Date Format: MM slash DD slash YYYY
  • *Specialized specs may include larger screen size or increased computer memory or capacity to run specific software to course-work and disability accommodation simultaneously.
  • Drop files here or
    Accepted file types: txt, rtf, jpg, bmp, gif, webp, png, pdf, doc, docx.
  • Drop files here or
    Accepted file types: txt, rtf, jpg, bmp, gif, webp, png, pdf, doc, docx.
    Ensure that the registered medical professional notes that the *specific* item(s) you have requested are needed for you because of and pertaining to your disability(ies).