Insert 3: Disability Awareness Form
DECAP Application Form
QUEEN’S UNIVERSITY BELFAST
Doctorate in Educational, Child & Adolescent Psychology
Disability Awareness Form 2016
Please note the completion of this form is optional
Background Information
The Doctorate in Educational, Child & Adolescent Psychology is a three year course which is
approved and accredited for the training of Educational Psychologists. About half the course is
university based while the other half consists of a variety of training placements. These
placements may be in any part of Northern Ireland and some may be in Great Britain.
The Disability Discrimination Act 1995 came into effect in December 1996 and the Special
Educational Needs and Disability Order (SENDO) came into effect in 2005. In line with this
legislation it is necessary for universities to make reasonable adjustments to accommodate a
person with a disability. Recruitment and Selection will continue to be made on the basis of the
merit principle.
In line the Disability Discrimination Act 1995, a disability is defined as:
“a physical or mental impairment which has a substantial and long term adverse effect
on your ability to carry out normal day to day activities”
1. Please indicate whether you have a disability - (please circle any which apply)
0
01
02
03
04
05
06
07
08
09
T
None
Specific learning difficulty (eg, dyslexia)
Visual Impairment
Hearing Impairment
Mobility/wheelchair user
Personal support needs
Mental health
Medical condition
Multiple disabilities
Other (not stated)
Autistic Spectrum
2. Do you consider that your disability would have an impact on your ability to complete the
course for which you have applied?
Yes/No
Yes (please provide appropriate details)
Insert 3: Disability Awareness Form
DECAP Application Form
3. Is there any reasonable adjustment which you believe is necessary to allow you to complete
the course for which you are applying?
4. Please outline relevant details regarding your disability and your anticipated support
requirements.
If you are successful in being offered a place on this course, a letter and questionnaire will be
sent to you to be returned to Disability Services to allow them to undertake a Needs Assessment
and advise the Course Director on your individual needs.
If you have any physical condition, which would require special arrangements for you to attend
for interview, you should inform the Course Administrator.
Applicant's Name
Address for
communication
E-mail
Signed
Date