Spring 2014 Checklist for
CURRENT UNDERGRADUATE APPLICANTS
The Application Due Date for Spring is January 6, 2014
(Applicants who apply after these dates and who qualify for SALT Center services may be subject to a Waiting List)
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Submit SALT Center application materials, which include the following:
● Complete the SALT application.
● Respond to essay question 1.
● Complete the Self-Awareness Survey.
● MAIL application-processing fee to: Max Jackson, SALT Center, 1010 N. Highland Avenue, Tucson, AZ 85721
($15.00 Arizona resident, $40.00 Non-Arizona resident) Make check payable to: University of Arizona
● Provide documentation of a learning or attention difference or respond to essay question 2.
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A SALT Center admission decision cannot be made until all required SALT application materials have been submitted.
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In addition, Transfer Students will need to be admitted to UA before the SALT Center can make an admission decision.
Submit diagnostic testing to the Disability Resource Center (DRC) for accommodations
● Separate and apart from the SALT Center, the Disability Resource Center (DRC) works with individual students
to identify reasonable disability accommodations.
● A reasonable accommodation is a reasonable modification in policies, practices, or procedures. Examples of
reasonable accommodations include, but are not limited to: text conversation to accessible formats, interpreter
services/real-time captioning, examination modifications, and making facilities readily accessible and usable by
individuals with disabilities.
● Students who wish to request reasonable disability accommodations should visit the DRC website at
http://drc.arizona.edu/ .
● Students can submit documentation electronically to the DRC at drc-info@email.arizona.edu.
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Submit SALT Center application materials to:
FAX: 520-626-3260 (cover sheet NOT necessary)
Email: maxj@email.arizona.edu
dcillo@email.arizona.edu
Spring 2014 Admissions Application for
CURRENT UNDERGRADUATE APPLICANTS
Please type. Applications will not be considered if all fields are not complete.
Status (check all that apply): _____Freshman _____Sophomore _____Junior _____Senior
_____Transfer
Full Name: _______________________________________________________________________
Last
First
Middle Initial
UA Student ID Number: _____________________________________________________________
Date of Birth: ___________________
Gender:
_____ Female
_____Male
(mm/dd/yyyy)
Permanent Mailing Address: ________________________________________________________
Number and Street
________________________________________________________________________________
City
State
Zip
Country (if applicable)
Student Cell Phone Number with area code: _____________________________________________
Student Email address: _____________________________________________________________
Home Phone Number with area code: __________________________________________________
Parent / Guardian email address: ______________________________________________________
Do you have a documented learning or attention difference?

Yes

No
*Please note if you are not submitting documentation of your learning or attention challenge with your
application, you are required to answer essay question 2.
By completing this application I am applying for participation in the SALT Center providing comprehensive services
designed to promote academic success to students who learn differently. I am aware that participation in this program will
result in additional fees payable to the University and that initially, I am committing myself to two consecutive semesters of
participation.
Signature: ______________________________________
Date: _________________
Spring 2014 Admissions Application for
CURRENT UNDERGRADUATE APPLICANTS
Essay Questions
Directions:
● All applicants should respond to essay question 1.
● If you are NOT submitting documentation of your learning or attention challenge, please answer
essay question 2.
● Please review the SALT Center website so you are familiar with our program and services before
writing your essays.
● Please include your name at the top of each sheet of paper.
ESSAY QUESTION
for ALL applicants
1. Describe your educational experience in college. What has led you to apply for academic
support services at the SALT Center?
ESSAY QUESTION for applicants who are not providing
documentation of a learning or attention difference
2. Describe your history of academic challenges and the support services you have used
to manage these differences.
Spring 2014 Admissions Application for
CURRENT UNDERGRADUATE APPLICANTS
Self-Awareness Survey
_______________________________________________________________
First Name
Last Name
Please provide your candid evaluation of your level of success in each area listed below. The Self-Awareness Survey
will provide your Strategic Learning Specialist with valuable information that will be used to create an Individualized
Learning Plan for you.
Below Average
Self-Advocacy
Motivation & Initiative
Independence
Maturity
Social Skills
Leadership Skills
Disciplined Work Habits
Organizational Skills
Time Management Skills
Ability to Adapt to New Situations
Resiliency & Perseverance
Communication Skills
Test Taking Skills
Study Skills
Writing Skills
Reading Skills
Math Skills
Second Language Skills
Average
Good
Very Good
Outstanding