Assistive Technology Applications Certificate Program Application

Thank you for your interest in the Assistive Technology Applications Certificate Program (ATACP). The ATACP is designed to provide a practical approach to the applications of Assistive Technology in meeting the needs of individuals with various disabilities in many settings.

The following form contains approximately 17 required fields and 18 optional fields. We recommend reviewing the entire form prior to filling it out, typing longer answers into Notepad, and copying/pasting them into the form.

Personal Information
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Disability Accommodations
Education (please list the highest degree or schooling completed)
Most Recent Institution
Other Institution
Experience (please list all relevant employment, volunteer and/or other activities)
Active/most recent position
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Other Experience
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Other Experience
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How did you learn about the CSUN ATACP and Center on Disabilities? (required)

* Refunds can be issued only if a request for cancellation is received in writing 30 days prior to live training date and on-line user name and password has not been used (less the $50.00 cancellation processing fee).