ACCES-VR Pre-Employment Transition Services (Pre-ETS) Interest Form

Room: C-Building, C-317
Phone: (718) 482-5446
acces-preets@lagcc.cuny.edu

Are you a student or staff/faculty member?(Required)

Student name(Required)

First Last

EMPL ID

If you are a student, please enter your EMPL ID.

Staff/faculty name(Required)

First Last

Preferred email address(Required)

Phone number/extension(Required)

Do you have a disability that affects employment?(Required)

Reason for referral:(Required)

Questions or comments

This field is for validation purposes and should be left unchanged.