Assistive Technologies Intake Form

Our online form is under construction, during this time, please email Erika.Skaftfeld@umanitoba.ca with the following information:

  • Name:
  • Student Number:
  • Email address:
  • Best way to contact:
  • Faculty:
  • Is CSG funding available? Yes, No
  • What will be required? Training, Consultation
  • What is the technology for? Exams, General coursework/studying, Other?
  • What are the areas of concern? Reading, Writing, Attention, Studying, Mind-mapping/Brainstorming, Other
  • Mac or PC
  • Previous working knowledge of any of the following?
    • Dragon Naturally Speaking:  Yes  No
    • Kurzweil 3000:  Yes  No
    • Read & Write Gold:  Yes  No
    • Zoom Text:  Yes  No
    • Jaws:  Yes  No
    • Window Eyes:  Yes  No
    • Inspiration:  Yes  No
    • Mind View:  Yes  No
    • Other software:
  • Additional Comments (What you are looking to use, previous program experience, concerns...):