UCCS OIS Summer Institute Application

Thank you for your interest in being considered for the one-week Office of Inclusive Services (OIS) Summer Institute!

We encourage students to complete this application with the minimal required support, but should review answers with a trusted family member, teacher, or friend before submitting.

Date: June 3-7, 2024 

Times: 9am-3pm 

Cost: $190

Contact: Julie Harmon; jharmon@uccs.edu

NOTE: The Summer Institute is a separate admissions decision from our 4-year certificate program. The Summer Institute is a standalone one-week summer program. Admission to the Summer Institute does not guarantee a student's eligibility and/or admission to the 4-year certificate program.

Interested in our 4-year certificate program? Visit our website to learn more and access the application.

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Email *
Student's first name? *
Student's last name?
 *
Where do you live? City, State, Zip Code
 *
Have you already completed an application for our 4-year certificate program this upcoming fall?
 *
How old will you be on June 1, 2024?
 *
Student e-mail address:
 *
Do you have your own cell phone?
 *
Guardian Contact Information Please complete the following section with your parent/guardian who will serve as the primary contact.
Parent/guardian first name:
 *
Parent/guardian last name:
 *
Parent/guardian e-mail address. This is the e-mail address that will be used for Summer Institute related communication.
 *
Parent/guardian phone number:
 *
How much assistance do you need with the following technology-based skills?
Texting
 *
Phone Calls
 *
Video Calling (e.g., FaceTime, Skype)Phone Calls
 *
Digital Calendar (e.g., Google or iPhone calendar)
 *
Emailing
 *
Microsoft Office (i.e., Word, PowerPoint, Excel)
 *
Phone Navigation App for Walking or Driving (e.g., Google Maps)
 *
Educational Information
Why do you want to participate in the Summer Institute?
 *
What are some things you do that make you feel at your best?

Examples: Personal strengths, hobbies, topics you enjoy learning or discussing.
What kind of situations can make you feel stressed?
 *
Medical & Behavioral Information: Please indicate current or past difficulties in the following areas, along with explanation, treatment or corrective measures. Select all that apply.
 *
Required
Is there anything else we haven't asked about that you would like us to know about you?
 *
I am aware that Summer Institute runs from 9am-3pm Monday-Friday, June 3-7, 2024 and overnight accommodations are not provided. *
I acknowledge that filling out this form does not ensure acceptance into the OIS Summer Institute. Notification of acceptance or rejection will be sent via email. *
I am aware that upon acceptance to the Summer Institute, a registration fee of $190 is required. *
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