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The Center on Disability and Community Inclusion (CDCI)

TRIPSCY

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Making A Difference In The Lives of Students With Print Disabilities


If you have Assistive Technology questions this is the one stop shopping place to get answers. Just take a minute to fill out the form and we will get back you shortly. You will get an individualized clear response. We promise to honor the confidentiality of all requests.

HelpLine - Technical Assistance Form
Your Information

School:
First Name:
Last Name:
Position:
Phone Number:
Email Address:

Your Students Information

Student ID #:
Student Age:
Student Grade:
Primary Student Disability:
Secondary Student Disability:

Briefly describe the student learning profile (assets and gaps). For example classroom, library, cafeteria, where the student is challenged with, accessing, the content, activity or communication:


Describe the academic environment that the student is working in:


Describe the task(s) that the child is having difficulty with For example, reading an assignment or textbook, word processing, auditory directions, using a computer to do homework. Please prioritize the most important ones first:


Describe any technology / AT that you are currently using or considering using for this student:


Please briefly describe past or current efforts to integrate tech supports. What would you like to accomplish next?


Last modified August 24 2009 10:54 AM

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