Forms | Nipissing University Skip over navigation
[X] close
Switch Contrast



In order to better meet the needs of students with disabilities at Nipissing University, this ​early identification and information form is made available for you to facilitate early communication with Student Accessibility Services.

The information requested within this form assists Student Accessibility Services to facilitate early accommodations and/or to arrange support services, wherequested by a student with a disability.

This information is collected according to the following principles:
  1.  Participant identification is voluntary.
  2. If you choose to identify yourself, all information is CONFIDENTIAL within Student Accessibility Services and cannot be released without your permission.
  3. Identification will not affect your admission status.
If completing a hard copy of the form, please forward it to Diane Sheldon ( or fax to 705-495-2850. 

Self Identification Form ​​ 

Returning Student Form


For those students who have previously registered with Student Accessibility Services, and will be registering again in the new school year, please fill out the form below and return it to the Student Accessibility Services Office to expedite your registration process.

Please complete this form for the Fall semesterReturning Student Form Fall

Please complete this form for the Winter/Spring/Summer semester(s):  Returning Student Form W/S/S


Virtual Intake Forms

for Online or Blended​ Education Students

If you are a student with a disability, registered in Nipissing's online or blended education courses, you can register with Student Accessibility Services (SAS) without visiting the North Bay campus.  

Once you have Self-Identified​ to SAS and provided current disability-related documentation to your Accessibility Consultant, you can register for our services by completing the following two forms and emailing them to your Accessibility Consultant from your Nipissing email account.

For more information about these services click here​ for the Student Handbook.

Note Taking Request Form

For those students who are registered with Student Accessibility Services, are eligible for note taking support, and would like to request a note taker for their course(s), please complete the following form in order to submit your request and begin the process of finding a note taker.

Requests are accepted throughout the academic year; however, it is preferred that students complete their request prior to the start of each term (when possible).  

If you are submitting this form after the term has already begun, we will endeavor to find a match for your course within 7 days of receiving the request; however, this is not guaranteed.

Note Taking Request Form​

Residence Special Accommodation Request Form

Residence Life strives to assist all students with disabilities and/or other specific personal challenges by providing residence accommodations that will meet their needs. In order to assist you, we require your help in determining how we can best address your specific needs.

We will only consider requests for a particular residence from students with disabilities that, if assigned elsewhere, will greatly affect their quality of life. Such requests include medical impairments, hearing or vision impairments, medical health conditions, physical challenges, or other permanent or ongoing medical conditions that would in some way affect the general wellbeing of the resident.

Please find the Residence Special Accommodation Request Form on the Residence Life webpage here​ 


Request for Final Exam Accommodations - Late Booking Form

In order to provide Final Exam accommodations to all students registered with Student Accessibility Services, we ask that any student requesting Final Exam accommodations book their exams with SAS by the posted deadline.

In the case that a student does not book his/her Final Exams with Student Accessibility Services by the posted deadline, the student must then complete a ‘Request for Final Exam Accommodations – Late Booking Form’. This form can be completed electronically, and can only be accepted through email if being sent from the student’s ‘’ email account. 

Upon submission, the request will be reviewed by the Manager of Student Accessibility Services, and the student will be contacted through email (‘’ email account), regarding the decision. 

Please submit the ‘Request for Final Exam Accommodations – Late Booking Form’ and email it to, or drop it off to Diane Sheldon in the Office of Student Development and Services (B210).

Request for Final Exam Accommodations – Late Booking Form
Nipissing University
100 College Drive, Box 5002, North Bay, ON, Canada  P1B 8L7
Tel: 705.474.3450 | Fax: 705.474.1947 | TTY: 877.688.5507
Brantford Campus
50 Wellington St.
Brantford, ON, Canada N3T 2L6
Tel: 519.752.1524 | Fax: 519.752.8372

© Nipissing University 2017DisclaimerPrivacyAccessibility