Application to the Learning Disabilities Program
at Northeastern University
The Learning Disabilities Program (LDP) offers placement to a limited number of students.
Should you have any questions about the Learning Disabilities Program or our application
process, please do not hesitate to contact Jennifer Newton at 617.373.4526 or j.newton@neu.edu.
Application to the Learning Disabilities Program includes:
 Completed application to the LDP (attached)
The application should be filled out by the student. It may be typed or handwritten.
 LDP Accommodation Request form (attached)
Current Northeastern students who are already registered with the DRC do not need to
submit this form.
 High school transcript (and college transcript, if you are transferring)
 SAT or ACT scores (official copy not required)
 High school IEP or 504 plan (if you were eligible)
Students who attended a private high school may submit a letter from the school attesting
to the accommodations and services they received there. Students transferring from
another institution should also submit information about their previous accommodations.
 Documentation of learning disability or attention deficit disorder
Documentation of a learning disability and/or attention deficit disorder generally
consists of the student’s most recent psychoeducational or neuropsychological
evaluation. Please see the reverse for additional information.
 In-person interview with LDP staff.
The in-person interview is a key element in our assessment of students for admission to
the LDP. Once you have been accepted to the University and submitted your LDP
application, please contact the LDP to schedule the required interview.
Application materials may be sent directly to:
Learning Disabilities Program
135 Forsyth Building
Northeastern University
360 Huntington Avenue
Boston, MA 02115
Application to the Learning Disabilities Program
Guidelines on the documentation of learning disabilities
and attention deficit disorders
At Northeastern, documentation of a learning disability and/or attention deficit disorder generally
consists of the student’s most recent psycho-educational or neuropsychological evaluation. It may
also include the student’s IEP or 504 plan from high school, other relevant history of services and
accommodations, and the student’s self report of his or her experience. Appropriate documentation
reflects a student's historical and current level of functioning, describes the substantial
impact(s)/limitation(s) the student experiences due to the disability, and includes a diagnostic
statement.
The staff of the LDP works with the Disability Resource Center to evaluate documentation and to
determine reasonable accommodations for students in the program. If you have specific questions
about documentation for a student applying to the LDP, you are invited to contact Jennifer Newton
at 617.373.4526 or j.newton@neu.edu.
Application to the Learning Disabilities Program
Application to the Learning Disabilities Program
Name _______________________________________________ Date ______________________
Address _________________________________________________________________________
_________________________________________________________________________
Phone (home) _______________________________ (cell) _______________________________
E-mail _________________________________________________________________________
When will you begin attending Northeastern (month/year)? ________________________________
Will you be a freshman? ___ High school attended: _____________________________________
Will you be a transfer? ___ College attended: __________________________________________
How did you find out about the Learning Disabilities Program?






College guide (Peterson’s or K&W)
Guidance counselor/college advisor
Web search
DRC specialist
NU Academic advisor
Other: _________________________________________________________________
The Learning Disabilities Program offers a limited number of scholarships each year toward the
LDP fee. Are you interested in being considered for this scholarship opportunity?
 Yes, I am interested. By checking this box, I understand and agree that the director of
the Learning Disabilities Program may consult with Student Financial Services for
determination of my financial need.
 No, I am not interested
Directions: The following questions must be answered by the student applicant. Students
may handwrite or type their answers.
1. Please describe your learning disability or attention deficit disorder.
Application to the Learning Disabilities Program
2. In what ways does your LD/ADD interfere with your schoolwork?
3. What are your academic strengths?
4. In what ways have you compensated for your LD/ADD? Please include your use of
accommodations, subject-specific tutoring, resource room, and personal strategies.
5. Why would you like to participate in the Learning Disabilities Program?
Application to the Learning Disabilities Program
LDP Accommodation Request Form
Current students who are already registered with the DRC do not need to submit this form.
1. So that we may best support you, please indicate the disability area(s) for which you are requesting
accommodations:
 ADHD
 Learning disability
 Other (specify _____________________________)
2. Are you currently under the care of a professional/specialist? (i.e., physician, counselor, academic coach)
 No
 Yes (please specify name(s), specialty): ________________________________________________
3. Are you currently taking medications?
 No
 Yes (please specify):________________________________________________________________
Prescribed by (please specify name(s), specialty): _______________________________________
4. What specific accommodations are you requesting at this time?
Accommodation: __________________________________________________________________________
Have you used this accommodation before?
 No
 Yes (please circle all that apply):
high school
college
SAT/ACT
other: ________________
Please explain how this accommodation is useful to you (that is, what barrier or difficulty do you experience
that this accommodation addresses?) ________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Accommodation: __________________________________________________________________________
Have you used this accommodation before?
 No
 Yes (please circle all that apply):
high school
college
SAT/ACT
other: ________________
Please explain how this accommodation is useful to you (that is, what barrier or difficulty do you experience
that this accommodation addresses?) ________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
LDP Accommodation Request Form
Accommodation: __________________________________________________________________________
Have you used this accommodation before?
 No
 Yes (please circle all that apply):
high school
college
SAT/ACT
other: _________________
Please explain how this accommodation is useful to you (that is, what barrier or difficulty do you experience
that this accommodation addresses?) ________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Accommodation: __________________________________________________________________________
Have you used this accommodation before?
 No
 Yes (please circle all that apply):
high school
college
SAT/ACT
other: ________________
Please explain how this accommodation is useful to you (that is, what barrier or difficulty do you experience
that this accommodation addresses?) ________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Accommodation: __________________________________________________________________________
Have you used this accommodation before?
 No
 Yes (please circle all that apply):
high school
college
SAT/ACT
other: ________________
Please explain how this accommodation is useful to you (that is, what barrier or difficulty do you experience
that this accommodation addresses?) ________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Accommodation: __________________________________________________________________________
Have you used this accommodation before?
 No
 Yes (please circle all that apply):
high school
college
SAT/ACT
other: ________________
Please explain how this accommodation is useful to you (that is, what barrier or difficulty do you experience
that this accommodation addresses?) ________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Student signature: _____________________________________________
LDP Accommodation Request Form
Date: __________________