Submit Your Application



Thank you for your interest in our Student Support Services for Students with Disabilities program! Please complete this application as thoroughly as possible. You cannot save and restart this application. You may want to review the included items, take some time to make notes and gather the required documents, and then return to submit your application. If you have any questions, please call our office at (507) 786-3256, email sssd@stolaf.edu or visit our website at https://wp.stolaf.edu/sssd

CONFIDENTIALITY OF INFORMATION Information you provide to the Student Support Services for Students with Disabilities (SSSD) program is protected by the Privacy Act. No one may see the information unless they work for St. Olaf College, SSSD, or if you specifically authorize them to see the information. In addition, some information you give to the SSSD Program is sent to the federal government (Department of Education). The information is necessary to confirm that you are eligible to participate in the program and helps the government to measure the program’s success. General Information:
First Name *
Middle Name
Last Name *
Cell Phone Number:
Please type in your personal and St. Olaf Email Address: *
Are you currently enrolled or will be enrolled at St. Olaf College in the upcoming semester? Yes No
Demographic Info:
Race/Ethnicity :
Race, American Indian or Alaskan Native * Yes No No response/Unknown/Not Disclosed No response/Unknown
Race, Asian * Yes No No response/Unknown/Not Disclosed No response/Unknown
Race, Black or African American * Yes No No response/Unknown/Not Disclosed No response/Unknown
Race, Hawaiian or other Native to Pacific Island * Yes No No response/Unknown/Not Disclosed No response/Unknown
Race, Hispanic * Yes No No response/Unknown/Not Disclosed No response/Unknown
Race, White * Yes No No response/Unknown/Not Disclosed No response/Unknown
Please check this box if you are a U.S. Citizen, National of the United States, or a person who meets the residency requirements for federal student aid?
Academic Info:
Current Grade Level: * No response/Unknown 1st yr., never attended 1st yr., attended before 2nd yr./sophomore 3rd yr./junior 4th yr./senior 5th yr./other undergraduate Dual degree program Graduate/Professional Student Not applicable (New summer participant- summer session only) Not applicable (prior-year participant no longer enrolled and bachelor's degree recipients) Not applicable (prior-year participant no longer enrolled at grantee institution)
Have you registered with the St. Olaf Disability and Access located within the Academic Success Center regarding your disability? Yes No Not Sure

Eligibility Questions:
Do you have a documented disability? * Yes No
How many people are in your household at home? * 1 2 3 4 5 6 7 8
Family Income Range: * $0 - $19,140 $19,141 - $25,860 $25,861 - $32,580 $32,581 - $39,300 $39,300 - $46,020 $46,021 - $52,740 $52,741 - $59,460 $59,461 - $66,180 Over $66,181
Most Recent IRS 1040 OR SSSD Income Verification Form
Are you a former TRIO Upward Bound (UB), Educational Talent Search (ETS), College Possible student or in a college preparatory program?
Were you enrolled in English as a Second Language (ESL) courses in high school? Yes No
What are your educational goals? *
Why are you interested in SSSD? Below is a list of our services. New Student Orientation Program Educational achievement and improvement Weekly first-year advising Academic, career, and financial aid advising Student leadership opportunities (conferences, Peer Leaders, workshops) Cultural Events Graduate School advising and preparation Assistance securing internships, research positions, and summer career-related work experience. Mental Health strategies and support (mindfulness and positive psychology workshops) Financial literacy workshops English Language Learning Support
List all the SSSD services you are interested in: *
Please describe how you will benefit from participating in the Student Support Services program for Students with Disabilities (SSSD)? *
What are your career goals? If you don’t know, it is OK to say unknown/exploring! *

Sign and Submit:
Applicant Signature * Please select a signature verification type.
Terms of Submission: By submitting this application, you acknowledge that all of the above information is correct and accurate to the best of your understanding. You also authorize program staff to receive your transcript, grades, financial data, documentation of disability, recommendations and evaluations in order to determine eligibility and fulfill the requirements of the Student Support Services for Students with Disabilities (SSSD) Program at St. Olaf College. You are in agreement with the Student Informed Consent Agreement. You authorize us to release information to the U.S. Department of Education.