Learner Support Registration

Please complete this form if you:

are sharing disability and medical information with the university.
have previously received additional exam arrangements, including extra time.
would like to arrange a free screening (post-enrolment) for a specific learning difference (SpLD) such as dyslexia, DCD-dyspraxia or ADHD.
would like to discuss support at university.

We encourage you to share information as soon as possible if you wish to discuss/access support at university. Support such as the Disabled Students’ Allowance (DSA) takes upwards of 10 weeks to arrange.

Contact

For further information please contact:

Learner Support
Email: learnersupport@harper-adams.ac.uk

Personal details

First name/given name

Last name

Student application number*

* Number stated on student correspondence from Harper Adams University

Confirm email

Contact telephone number

Support needs

Please indicate which of the following apply. The Learner Support team can then provide further guidance on support available:

I have a specific learning difference, for example, dyslexia, DCD-dyspraxia or ADHD.

I have a disability, for example, visual or hearing impairment, physical disability, long term medical condition, reduced mental health.

Please provide any further details in the box below:

I have previously received additional exam arrangements.

Please Note: previous support arrangements including exam arrangements such as extra time do not automatically transfer over from school/college. .

Please provide details of any support received including any exam support:

I think I may have a specific learning difference, for example, dyslexia, DCD-dyspraxia or ADHD and would like to request a screening.

None of the above apply, but I would like to arrange a meeting with Learner Support to discuss support options.

Disabled Students' Allowance

Have you applied for Disabled Students' Allowance?

Yes, I've applied
No, I haven't applied

Tick if you have had a Needs Assessment

Supporting information

If you have any supporting information, please share this with us to help us discuss your support needs.

If applicable, please upload evidence of your disability/specific learning difference to this form (for example, medical certificate, psychological/diagnostic assessment) and any associated assessments/exam arrangement information (for example, needs assessment/JCQ access arrangements).

You can upload up to three documents in PDF or JPEG format:

Choose file 1:

Choose file 2:

Choose file 3:

File sharing

You can also email documents to learnersupport@harper-adams.ac.uk - we recommend you use a file sharing service, such as DropBox or OneDrive, to share your documents securely with us.

University disclosure

The information provided on this form will be dealt with in the strictest confidence and will only be used by the university. Information is not shared with any third party or disclosed externally. It is beneficial to the applicant for the university to be aware of any disability or specific learning difference that you have. We can then provide appropriate support. We only notify staff who need to know of your disability/specific learning difference.

Please select the relevant consent box:

Yes, I consent to information being shared with relevant Harper Adams University staff.
No, I do not consent to appropriate Harper Adams University staff being informed of my specific learning difference/disability.**

**Our ability to provide you with relevant support is restricted without your consent.

Privacy notice

Under GDPR and Data Protection Act 2018 you have rights in relation to your data. You have the right of access, rectification, erasure, and restriction on processing. To find out more about your rights or how your data is used contact the data protection officer on dpo@harper-admas.ac.uk

After submission, the Learner Support team will be in contact with you with further information.

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