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Disability Resource Center
Disability Resource Center – Resources
Disability Resource Center - Cardinal Success Coach Program
Disability Resource Center - Cardinal Success Coach Program Application
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Cardinal Success Coach Program Application
Cardinal Success Coach Program Application
First Name (preferred)
*
Last Name
*
Legal Name (if different from preferred)
ID#
*
Pronouns
(optional)
she/her/hers
he/him/his
they/them/theirs
Your Email Address
*
Phone
*
I would like to begin coaching during the following semester:
*
Fall 2025
Spring 2026
How many semesters have you been at UofL?
*
- Select -
0 - This is my first semester.
1
2
3+
Have you registered with the Disability Resource Center?
*
Yes
No
Are you a transfer student?
*
Yes
No
Are you a client of the Kentucky Office of Vocational Rehabilitation?
*
Yes
No
How many times per week would you like to work with a coach?
*
- Select -
1
2
3
I have an effective system for keeping myself organized.
*
- Select -
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I can effectively prioritize when managing multiple tasks.
*
- Select -
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
In your own words, why do you want to participate in the Cardinal Success Coach Program?
*
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