Westfield State University

Banacos Academic Center

Westfield State University is committed to having accessible campus facilties and programs. The Banacos Academic Center disabilities programs are available to provide support services for students with disabilities. Entering students often have questions about whether to tell anyone they have a disability or whether they should use their accommodations when they get to college. The staff at the Banacos Academic Center strongly encourages students to talk about the differences between your previous school and Westfield State University before making those decisions. Personal information that students give us is kept private within the disabilities programs' staff.

Please fill out this form if you are:

1) New to Westfield State University as a transfer or undergraduate (day division or DGCE) or graduate student;

2) Have one or more disabilities; and,

3) Even if you do not anticipate requesting reasonable accommodations.

The information submitted by this form will go to the Banacos Academic Center which houses Disability Services and the Learning Disabilities Program. This information will be used to inform the Center of who has a disability on campus so that we can update you on various information such as the services available on campus, how to request accommodations, and items of interests such as scholarships or events related to disability and accessibility. While the number of students with disabilities and types of disabilities may be shared for informational purposes and to support the development of accessible facilities on campus, your personal information will remain private according to the requirements of the Family Educational Rights and Privacy Act of 1974 (FERPA). 

DISABILITIES NOTIFICATION FORM

Please note that submitting this form does not register you with the office or constitute a request for services.

First Name	*
Last Name	*
Expected graduation year from WSU	*	2023 2024 2025 2026 2027 2028 2029 GRAD other
Do you live on campus?	*	No Yes
Are you a transfer student?	*	No Yes
Are you a graduate student?	*	No Yes
WSU Email address	* We require a WSU email address to confirm that you are a student here.
Do you have a disability?	*	No Yes I am not sure
Please describe the disability/ies:
Do you anticipate requesting reasonable accommodations and other services?		No Yes
Please describe any anticipated requests:
Please tell us about any questions you have