Form for persons applying for aid of the OPD

• Last name*

• First Name*

• PESEL ID*

  PESEL ID

  Im foreign student Check if you do noyt have a PESEL ID

• Phone*

• Email address*
  IMPORTANT! Enter address registered in the USOSweb system.

• Confirm emeil*

• Student record book number/student number*

• Year of studies, program and faculty*
  Makx 1000 characters. for persons studying more than one program, please indicate all the programs Characters count 0.
  

• Level of education*wymagane (please check the appropriate type of studies):

  first cycle degree programssecond cycle degree programsintegrated master’s degreethird cycle degree programs/PhD Schoolpost-graduate studies

• Form of studies*required

  full-time studiespart-time studies (extramural)part-time studies (evening)not applicable

• Disability level*wymagane
  please indicate the relevant disability status declared by a medical committee

  significantmoderatemildno status declared

• Special diseases ^[*] explanation
  please check appropriate, if applicable

  Parkinson’s diseasemultiple sclerosisparaplegia, tetraplegia, hemiplegiaserious vision impairment (blindness) and vision impairmentdeafness and hearing or speech impairmentHIV and AIDS carrierepilepsychronic mental illnessmental retardationmyasthenia gravislate diabetes mellitus complications

  Please upload documentation on special disease. Accepted file formats: jpg, jpeg, png, gif, pdf, doc, docx. Max file size - 4mb, Max files to upload - 6
  

• Description of health problems
  Max1000 characters.
  Characters count: 0.
  

• Difficulties in studying
  Max1000 characters. please describe the difficulties appearing during the studies that urged you to seek aid from the OPD and/or difficulties related to the process of learning during your previous education Characters count 0.
  

• Type of the aid expected
  Max 1000 characters. If you have trouble determining the type of aid, please contact the student affairs consultant
  Notice! We do not consider this information as a request. To get specific aid or borrow an equipment please fill required application AFTER sending this form.opens in new tab Character count: 0.
  

• * I hereby consent to the processing of my personal data, including, but not limited to the special categories of personal data as defined by Article 9(1) of the GDPR by the University of Warsaw, with its registered office at ul. Krakowskie Przedmieście 26/28, 00-927 Warsaw, for the purpose of providing aid by the Office for Persons with Disabilities related to ensuring conditions that would allow full participation in the university admission process for persons with disabilities in order to pursue education (including attending studies according to the individual study organization), education and research activity.

• * I have read and I'm accepting the Terms of online applications to OPD

Notice. The "send" button will not activate if you don't accept the terms displayed above.