Accessible Learning Services Registration Form

Welcome to Accessible Learning Services

Note: You will be required to enter your George Brown College 9-digit student ID number to submit this Registration Form. If you do not have one or need additional assistance, please exit this form and then contact Accessible Learning Services by emailing alsregister@georgebrown.ca or by contacting the Welcome Desk at any campus for assistance. If you have already filled out this form once, you will not be able to submit it again.

With a focus on academic accommodations and accessibility, Accessible Learning Services at George Brown College is committed to providing equitable opportunity, individualized accommodations and supports to students with disabilities throughout their academic experience. Whether you identify with experiencing mental health challenges, medical diagnoses, or identify with a disability, we meet students in a safe space, where they frame their own, unique lived experience.

Completion of this registration form is a first step in the collaborative accommodation planning process.

In accordance with the Ontario Human Rights Code, you are not required to disclose your specific diagnosis to Accessible Learning Services to receive accommodations. However, documentation outlining the functional impacts of your disability is required and will help us understand your strengths and challenges so that we can determine the most appropriate accommodations to support your learning.

If you need help with the Confidential Registration Form or if you’re having trouble getting documentation, let us know and we’d be more than happy to help. Please contact ALS at alsregister@georgebrown.ca if you need assistance and we will review options to support you.

Assistive Technology can be used to access this form. A free screen reader can be downloaded from Natural Readers. If you have access to GBC AppsAnywhere, you can download and install Read&Write.

Statement of Confidentiality

Accessible Learning Services of George Brown College agrees to keep all information you share in strictest confidence. Under the Freedom of Information and Protection of Privacy Act (FIPPA) we are unable to disclose any information without signed consent.

We are required by law to disclose any information in the following situations:

1. Known and suspected instances of children who are or may be in need of protection.

2. Cases involving imminent risk of physical harm to oneself or another.

3. Known instances of inappropriate sexual contact by a regulated health care provider.

4. Or when subpoenaed for records or testimony by the courts.

When you register with Accessible Learning Services, a confidential digital file will be started. This file will contain information related to your intake, appointments, accommodations, services, and contacts with our office, as well as your documentation of disability. This data will be entered into a computer program for data collection and statistical purposes. When reporting statistics, only group data is used without names of individuals or personal identifying information. Only Accessible Learning Services staff will have access to your file. Please visit our website for more information on Privacy and Confidentiality.

Internal Consent

I give permission to Accessible Learning Services staff to address questions/concerns related to my Accommodation Letter and for obtaining/disclosing information for the purpose of intervening/advocating on my behalf. I agree that Accessible Learning Services staff can discuss the nature of the functional impact of my disability and answer questions related to my Accommodation Letter from Administrators, Faculty, and Staff. I agree that Accessible Learning Services can obtain or disclose information to other service areas of George Brown College, as required, to support my success. I understand that Accessible Learning Services may be required to obtain or disclose information to student services at post-secondary institutions other than George Brown (e.g., McMaster University, Ontario Learn) if I am enrolled in a program that is jointly administered between George Brown College and another post-secondary institution.

Consent

External Consent

Student information will not be disclosed to a third party unless specific instruction is given by the student and a release form has been signed. Please discuss external consent with your Accessibility Consultant.

Personal Information

First Name

Last Name

Middle Name

Preferred Name

Pronouns

Name Pronunciation

George Brown College ID

Enter your 9-digit student ID number. If you do not have one, please contact alsregister@georgebrown.ca for support. Please double check to ensure your student number is accurate before submitting.

GBC Email Address

If you don't have your George Brown College email address at this time, please provide an alternate email address.

Alternate Email Address

Primary Phone Number

What is your preferred method of contact?

May we leave a message?

Do we have permission to utilize your email for upcoming events/workshops/ALS activities?

Other:

Please check all that you are currently receiving

Are you an international student?

Disability/Medical Information

Providing a diagnosis is not required but if you decide to provide one, Accessible Learning Services will not disclose any information regarding your diagnosis or the disability documentation you share without your written consent.

Nature/Type of Disability (please check all that apply)

If you would prefer not to disclose a diagnosis, please select one of the 'I choose not to disclose' options at the bottom of the list.

If other, please specify

Disability/Medical Documentation

Students are required to provide documentation outlining the functional limitations of their disability to receive academic accommodations. Disability documentation will need to be provided at least 3 days prior to an intake appointment with an Accessibility Consultant. A disability diagnosis does not need to be specified. If you do not currently have documentation, continue with the registration process as temporary accommodations may be available to you while documentation is being acquired.

Please refer to this link for more information.

Upload Medical/Disability Documentation

Please upload your documentation (e.g. - Individualized Education Plan (IEP), Psychoeducational Assessment, Disability Verification Form, etc.).

Please see our Guide to Disability Documentation on our webpage for more information.

To upload documentation:

Click the 'Add Item' button below
Provide a name for the document in the 'Document Type' field
Click the 'Browse' button then navigate to where the document is and upload it. Name documents using the following format, 'STUDENT NUMBER, ALS DOCUMENTS' (for example 000000000, ALS DOCUMENTS.pdf)
(optional) Provide a description for the document in the 'Description' field.
If you would like to add additional documents, please repeat steps 1– 4.

Password to access documentation (if needed)

Optional: Self Assessment

Skills Reflection

Reflect on skills such as reading, writing, focusing, organizing and managing your time, problem solving, engaging in group work, interacting socially, studying, and taking tests. Determine whether these skills represent areas of personal strength or areas where accommodations and support are needed.

Academic Challenges

If you do not have a disability diagnosis and suspect you may have a disability, describe the academic challenges you are currently experiencing and how it affects your learning and/or academic skills.

Is there anything else you would like us to know that will help us provide accommodations for you?

Next Steps

For your first appointment with an Accessibility Consultant, you will receive an email within 3 business days in your George Brown College email account from the ALS Front Desk with the name of your Accessibility Consultant and instructions on how to book an appointment.

Do you require an ASL Interpreter, Computerized Notetaker or Deaf-Blind Intervenor for your appointment?

Optional Questionnaire

George Brown College (GBC) is committed to fostering a community that is focused on diversity, equity, and inclusivity. Through this voluntary and confidential survey, GBC hopes to build an understanding of our student population. The data collected in this form will be kept confidential and will provide additional information to your Accessibility Consultant prior to your first appointment.

Privacy: This survey does not ask you any questions that will identify you personally. This data will be analyzed and used to develop future programs within Accessible Learning Services and assist in addressing any gaps in representation, to ensure an equitable and inclusive environment for all of our students.

What is/are your source(s) of income? (Select all that apply)

What is your housing type? (Select all that apply)   

Have you ever cut the size of your meals or skip meals because there wasn’t enough money for food?

Age

Please indicate which age group you belong to:

Do you identify as First Nations, Métis, and/or Inuit?

Racial Identity

In our society, people are often described by their race or racial background. For example, some people are considered “White” or “Black” or “East/Southeast Asian,” etc. Which race category best describes you? (Select all that apply)

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If other, Racial Identity

Gender / Gender Identity

Gender identity is each person’s internal and individual experience of gender. A person’s gender identity may be the same as or different from their birth-assigned sex. What is your gender identity? (Select all that apply)

If other, Gender Identity

Sexual Orientation

Sexual orientation is a person’s experience of intimate, emotional, romantic and/or sexual attraction. What is your sexual orientation? (Select all that apply)

If other, Sexual Orientation

Religion / Faith

Indicate any religion or spirituality with which you identify. (Select all that apply)

{"display_name":"Religion \/ Faith","hidden_field_name":"ms_field_6","init_id":"ms_field_6","init_link":"","has_autocomplete":false,"has_hierpicklist":null}

If other, Religion/Faith