OSS/SI Registration Form

* indicates a required field

Student Information

If you are a student with a disability and wish to receive consideration for reasonable accommodations, you must register with the Office of Specialized Services and Supplemental Instruction (OSS/SI). This form will ask you to provide basic information (name, NJCU information, etc.) before you request your accommodations.

Please upload your disability documentation with this registration form. This information can also be submitted via email (jaitken@njcu.edu ), fax (201-200-3083), or sent by mail to the address below.

Specialized Services and Supplemental Instruction
New Jersey City University
2039 John F. Kennedy Boulevard
Karnoutsos Hall, Room 105
Jersey City, NJ 07305-1597

Examples of appropriate documentation include a 504 Plan, IEP, Educational/Learning Assessment, Psychological Evaluation, or Neuropsychological Evaluation. A letter from a physician or therapist printed on letterhead may also be accepted. Documentation guidelines are available on our website https://www.njcu.edu/oss.

Once you complete this form and submit your documentation, a representative from the OSS/SI Office will review the information and schedule a meeting with you to discuss your request for services and accommodations.

You will then be directed to submit an accommodation request form for the upcoming semester.

Please note the Accommodation Request Form must be completed every semester for which you are enrolled. Note that accommodations cannot be provided on a retroactive basis, so timely submission of your requests is highly recommended.

Please use your university issued email address

Registration Questions

Are you registered with the NJ Commission for the Blind?Required
Are you registered with the Division of Vocational Rehabilitation Services (DVRS)?Required
Acknowledgment and Certification of UnderstandingRequired
This Acknowledgment and Certification of Understanding ("Acknowledgement") is to let you know that by submitting an electronic signature, you are providing an electronic mark, that is held to the same standard as a legally binding equivalent of a handwritten signature provided by you. For purposes of the acknowledgement, a digital mark is considered a typed legal First and Last name (legal name may include middle name, initial or suffix) followed by the typed date. I also warrant the truthfulness of the information provided in this online form.
Supporting Documentation
Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.