Intake Request Form

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Student Information

Instructions: Complete the form to the best of your ability. Required(*) fields must be filled out for the form to submit. Please provide your KSU-issued email address as this is the primary method that Student Disability Services will contact students after review of the Intake Form. 

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MajorRequired
Accounting
Accounting Certificate
Accounting-Interest
African & Af. Diaspora Studies
African&Diaspors St-Interest
Agriculture
American Studies
Analytics and Data Science
Anthropology
Anthropology-Interest
Apparel Product Development
Apparel Textile Technology
Apparel and Textiles
Applied Computer Science
Applied Computer Science-Int
Applied Engineering
Applied Peacebuilding
Applied Stats & Analytics
Architecture
Architecture Tech
Architecture/Landscape Arch/Urban Planning
Art
Art Education
Art Education-Interest
Art History
Art History-Interest
Art-Interest
Asian Studies
Auditor
BAS Manufacturing
BAS Supply Chain Logistics
BS in Public Health
Biochemistry
Biochemistry Interest
Biology
Biology - Biochem and Molec Bi
Biology - Bioinformatics Track
Biology - Biotechnology Track
Biology - Education Track
Biology - General Track
Biology - Pre-Professional Tra
Biology Education
Biology Education Interest
Biology-Interest
Biotechnology
Biotechnology-Interest
Black Studies
Bus Admin Marketing Conc
Business
Business: Accounting
Business: Advertising
Business: Finance
Business: Management
Business: Marketing
Business Administration
Business Fundamentals Cert
Business Intelligence
Business Management (BAS)
Business-UG-Undeclared
CER0 Robotics Prgrming Cert
CER0 in Geographic Info Sci
CER0 in Info Sec & Assurance
CER0 in Nonprofit Mgt & Ldr
CER1 in Acad Social Car Enr
CER1 in Acd Inclusive Adult Ed
CER1 in Adv Leadership Car Dev
CERG Autism Spectrum Disorders
CERG in Leadership Spt & ES
CERM in Higher Ed. Admin
CGD&D Distributed Mobile Track
CGD&D Media Production Track
CGD&D Planning Mgnt Track
CGD&D Simulation Infom Track
Cert-Interd Mus and Entr Bus
Cert-Non-Degree-Grad-Fin-Aid
Certif in Systems Eng
Certificate-Non-Degree-Grad
Chemical Sciences
Chemistry
Chemistry-Interest
Civil Engineering
Civil Engineering Technology
Cnst Mgnt Facilities Man Conc
Cnst Mgnt Heavy Cnst Mgnt Conc
Cnst Mgnt Land Devel Conc
Cnst Mgnt Speciality Cnst Conc
Coaching Education
Communication
Communication-Interest
Communications
Comp & Tech
Computational Applied Math
Computer Eng. Tech.
Computer Engineering
Computer Engineering Tech
Computer Game Design & Dev
Computer Game Design & Develop
Computer Science
Computer Science Foundations
Computer Science-Interest
Construction Engineering
Construction Management
Creative Writing Grad Cert.
Criminal Justice
Criminal Justice Interest
Cross Registration
Culinary Sust & Hosp-Interest
Culinary Sustainability & Hosp
Curriculum and Instruction
Cybersecurity
Cybersecurity - Interest
Cybersecurity Certificate
Cybersecurity Interest
Cybersecurity-Interest
Cyersecurity Certificate
Dance
Dance-Interest
Data Analytics & Intell Techno
Data Management and Analytics
Data Science and Analytics
Data Sciences and Analytics
Digital Animation
Digital Animation-Interest
Digital Financial Technologies
Digital and Social Media Cert.
Diversity & Comm. Engagement
Doctorate of Business Admin
Doctorate of Nursing
Dual Enrollment Honors Program
Dual Enrollment Program
EDS - Curriculum & Instruction
EDS Curriculum & Instruction
EDS Educational Leadership
EDS Instructional Technology
EDS Secondary & Middle Grades
EDS Special Education
EDS-Instructional Technology
EE as 2nd Degree Post ECET
EE as 2nd Degree Post CPET
Early Birth-Kndergdn Interest
Early Childhood Birth to Kinde
Early Childhood Educ-Interest
Early Childhood Education
Economics
Economics-Interest
Ed Leadership for Learning
Educ Certificate NonDegree UG
Education
Education-UG-Undeclared
Educational Leadership
Elec. Eng. Tech.-Biomedical Op
Electrical & Computer Eng
Electrical Eng. Tech.
Electrical Engineering
Electrical Engineering Tech
Elementary Education
Elementary Education-Interest
Engineering
Engineering: Chemical
Engineering: Civil
Engineering: Electrical
Engineering: Mechanical
Engineering: Systems
Engineering Management
Engineering Technology
Engineering Technology : Electr
English
English Educ Sec-Interest
English Education
English and Professional Commu
English to Speakers Other Lang
English-Interest
Enterprise IT Management
Entrepreneurship
Entrepreneurship-Interest
Environmental Design
Environmental Eng Tech
Environmental Engineering
Environmental Engineering Tech
Environmental Science
Environmental Science-General
Environmental Sciences
Exercise & Health Sci-Interest
Exercise & Health Science
Exercise Science
Exercise Science-Interest
Facilities Management
Finance
Finance-Interest
Financial Technology Cert
Fine Arts/Graphic Design
Focus Area - Arts
Focus Area - Business & Mgmt
Focus Area - Computing
Focus Area - Education
Focus Area - Engr & Math
Focus Area - Health Prof
Focus Area - Humanities
Focus Area - Sci
Focus Area - Social Science
GRAD Architecture - Urbanism
Gender and the Workplace
General Studies
Geographic Info Sci Interest
Geographic Information Sci
Geographical Info Systems
Geographical Information Sys
Geography
Geography Interest
Geospatial Sciences
Grad Cert in Info Secur
Grad Cert in Info Secur: Assura
Grad Cert in Info Tech
Grad Cert in QA - Green Belt
Grad Cert in Software Eng
Grad Trans Cert in Com Scienc
Grad Trans Cert in Info Tech
HPAL Interest
HPCC & Big Data Analytics
Health & Phys Activity Leaders
Health & Phys Ed-Interest
Health & Physical Education
Health Info Tech
Health Information Technology
Health Mgt & Informatics
Healthcare Mgt & Informatics
High Performance Computing
History
History Education
History Education-Interest
History-Interest
Hospitality Management
Hospitality Mgt-Interest
Hotel and Restaurant Management
Human Services
Human Services Interest
IS - Pre Law Conc
Ind & Charter School Ldshp
Industrial & Systems Eng.
Industrial Engineering Tech
Info & Instructional Design
Info Tech Foundations
Info Tech Health Info
Inform Sec & Assur-Interest
Inform Security & Assurance
Information Design and Com
Information Design and Comm
Information Sec Tech
Information Sec. & Assurance
Information Systems
Information Systems-Interest
Information Tech (WEB)
Information Tech Sec
Information Technology
Information Technology CIT
Information Technology TCIT
Information Technology(BAS)
Instruct Design (Grad Cert)
Instructional Technology
Instructional Technology (EDD)
Integrated Global Comm
Integrated Health Science
Integrative Biology
Integrative Stu-Interest
Integrative Studies
Integrative Studies - Interest
Intelligence & Homeland Sec
Intelligent Robotic Systems
Interactive Design
Interdisciplinary Engineering
Interdisciplinary Studies
International Affairs
International Affairs-Interest
International Bus-Interest
International Business
International Conflict Mgmt.
International Studies
Jour & Emrg Media Interest
Journalism and Emerging Media
Land Development
Land Surveying
Land Surveying (Certificate)
Leadership and Ethics
Learning Design & Technology
Logistics
MA in Art and Design
MAPW-Professional Writing
MBA-General
MED-Adolescent Education
MED-Early Childhood Education
MED-Educational Leadership
MED-Inclusive Education
MED-Instructional Technology
MET- Eng Des Graphics Conc
MS - Applied Stats & Analytics
MS - Computer Science
MS - Construction Management
MS in Artificial Intelligence
MS in Cybersecurity
MS in First Year Studies
MS-Applied Exercise & Health S
MS-Applied Statistics
MS-Conflict Management
MS-Information Systems
MS-International Policy Mgt
MSN-Adv Care Mgt & Leadership
MSN-Family Nurse Practitioner
MSN-Leadership in Nursing
MSN-PC Nurse Pract-Interest
MSN-Primary Care Nurse Pract
Management
Management-Interest
Manufacturing Operations
Marketing
Marketing-Interest
Master of Accounting
Master of Arts in Teaching
Master of Business Admin
Master of Public Admin
Master of Social Work
Math Educ Secondary-Interest
Math as a 2nd Major
Mathematics
Mathematics -Education Track
Mathematics Education
Mathematics-Interest
Mechanical Engineering
Mechanical Engineering Tech
Mechatronics Engineering
Media & Entertainment
Media & Entertainment-Interest
Middle Grades ED-Interest
Middle Grades Education
Modern Lang & Culture-Interest
Modern Language & Culture
Music
Music Educ-Interest
Music Education
Music Interest
Music Performance
Music Performance-Interest
Music-Interest
New Media Arts
Non-Degree Graduate
Non-Degree Undergraduate
NonDegree Grad Business
NonDegree Grad Comp
NonDegree Grad Comp: SWE
NonDegree Grad Education
NonDegree Grad Hum
NonDegree Grad Hum: SocSci
Nonprofit Mgt & Social Innov
Nursing
Nursing RN-BSN
Nursing-Accelerated
Nursing-Interest
Online Teaching Certification
Org & Prof Comm-Interest
Org & Prof Communication
PHD in Analytics and Data Sci
PHD in Business Administration
PM Nurse Educator
Personalized Learning Cert
Philosophy
Philosophy-Interest
Physics
Physics - Education Track
Physics BA
Physics BS
Political Science
Political Science-Interest
Pre-Design Arch
Premed
Pro Writ International Aud
Production Design
Professional Editing & Publish
Professional Sales
Professional Sales-Interest
Programming (Cert)
Project Management
Prosthetics and Orthotics
Psyc-Clinical
Psyc-Clinical: Counseling Track
Psychology
Psychology - Engineer Psy Trk
Psychology - Ind
Psychology - Ind: Org Psy Trk
Psychology-Interest
Public Health Ed. - Interest
Public Health Education
Public Relations
Public Relations-Interest
Quality Assurance
Quality Principles
Reading
STEM Educ Endorsement
Screen & Television Writing
Secondary & Middle Grades EDD
Secondary & Middle Grades Edu
Secondary Education
Secondary Education-Interest
Six Sigma Green Belt Cert
Six Sigma Green Belt Cert.
Sociology
Sociology-Interest
Software Engineering
Software Engineering Cert.
Software Engineering Found
Software Engineering Fund
Special Education
Special Education Certificate
Specialty Construction
Sport Management
Sport Management-Interest
Supply Chain Logistics
Surveying and Mapping
Systems Eng-Manuf & Logistics
Systems Engineering
TCOM -Information Design
TCOM-Digital Media & Graphics
Tcher Leadership for Learning
Teacher Leadership
Teacher Leadership (EDD)
Teacher Leadership Certificate
Tech and Prof Communication
Technical Comm (Grad Cert)
Technical Communication
Telecommunications Eng Tech
Theatre & P Studies-Interest
Theatre & Performance Studies
Transient Graduate
Transient Undergraduate
Undeclared
Undeclared - Arts
Undeclared - Business & Mgmt
Undeclared - Business & Mgt
Undeclared - Computing
Undeclared - Education
Undeclared - Engr & Math
Undeclared - Health Prof
Undeclared - Humanities
Undeclared - Sci
Undeclared - Social Science
University Undeclared
Visual Comm
Visual Comm: Graphics(Grad Cer)
Writing & New Media
Are you a veteran?Required
Are you a Vocational Rehabilitation Agency client?Required

Accessibility Specific Information

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Please upload your documentation here. If you have difficulties, you can also email it to Student Disability Services office at sds@kennesaw.edu or submit it via fax or mail. (View the "Contact Us' page for mailing and fax information on our website.)